Heart failure risk high in patients with systemic autoimmune inflammatory diseases

Patients with systemic autoimmune inflammatory diseases—including systemic sclerosis, systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA)—face an increased risk of heart failure (HF), as suggested in a retrospective study.

Researchers looked at the electronic health records of 182,795 adult patients (median age 64 years, 71.5 percent female, 83.8 percent White) with systemic sclerosis (n=5,555), SLE (n=19,730), RA (n=54,711), psoriatic arthritis (PsA) (n=9,871), inflammatory bowel disease (IBD) (n=90,476), or HIV (n=2,452).

Over a median follow-up of 5.6 years, a total of 10,779 (7.9 percent) patients received a diagnosis of new‐onset HF. The proportion of patients with incident HF was 14.4 percent in the systemic sclerosis group, 11.6 percent in the SLE group, 10.4 percent in the RA group, 5.9 percent in the PsA group, 5.5 percent in the IBD group, and 6.1 percent in the HIV group.

Relative to controls who were free of systemic autoimmune inflammatory diseases, the risk of incident HF was significantly elevated among patients with systemic sclerosis (adjusted hazard ratio [aHR], 2.81, 95 percent confidence interval [CI], 2.57–3.08; p<0.001), SLE (aHR, 1.64, 95 percent CI, 1.56–1.74; p<0.001), or RA (aHR, 1.54, 95 percent CI, 1.47–1.61; p<0.001).

Beta‐blocker use at baseline was associated with decreased incident HF in a combined group of systemic sclerosis, SLE, and RA (aHR, 0.7, 95 percent CI, 0.6–0.8; p<0.001).