Degenerative valvular heart disease (VHD) is a prevalent subtype of VHD that mostly affects people over 50 in high-income nations and is caused by age-related degenerative pathogeneses. There is growing evidence that degenerative VHD, including aortic stenosis (AS) and mitral regurgitation (MR), is influenced by immunological dysregulation and chronic inflammation.
Despite the growing evidence that RA and degenerative VHD share comparable inflammatory processes and risk factors, little is known about how they relate to one another. Thus, this study was set to examine the relationship between the risk of various forms of degenerative VHD and the prevalence of RA.
Cox proportional hazards models, with sequential adjustments for demographics, lifestyle factors, and comorbidities, were used to evaluate the relationship between prevalent RA and new-onset degenerative VHD.
Among 492 745 UK Biobank individuals who did not have VHD at baseline. 8 subtypes of degenerative VHD were identified in this study: tricuspid stenosis, tricuspid regurgitation, mitral stenosis, aortic regurgitation, aortic stenosis, pulmonary stenosis, and pulmonary regurgitation.
Over a median follow-up of 13.71 (interquartile range: 12.71–14.55) years, 359 instances of degenerative VHD were reported among individuals with RA (n=6673), whereas 13 518 cases were reported among people without RA (n=486–072) over a median follow-up of 13.78 (interquartile range: 12.96–14.51) years.
Aortic stenosis (hazard ratio [HR], 1.64 [95% CI, 1.40–1.92]), aortic regurgitation (HR, 1.69 [95% CI, 1.34–2.13]), and mitral regurgitation (HR, 1.54 [95% CI, 1.32–1.81]) were the three types of new-onset degenerative VHD that were significantly associated with RA after full adjustment.
No significant association was found between RA and other subtypes of degenerative VHD. Additionally, sex subgroup analysis showed that RA and sex interacted to increase the risk of aortic stenosis (P for interaction=0.02) and mitral regurgitation (P for interaction=0.04) in women.
Overall, while there was no significant correlation between RA and incident degenerative MS, TR, or PR, the results of this cohort analysis suggested that RA was linked to the development of degenerative AS, AR, and MR.
Furthermore, incident AS and MR may be more likely to occur in women with RA. In order to incorporate these findings into primary prevention in high-risk groups, more research is required.
Source:
Wang, Z., Lv, J., Qian, X., Li, Z., Yin, Z., Wang, C., Zhao, S., Gao, X., & Wu, Y. (2025). Association between rheumatoid arthritis and the risk of incident degenerative valvular heart disease: Evidence from a prospective cohort study. Journal of the American Heart Association,. https://doi.org/10.1161/JAHA.125.042025
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