DMARD therapy in autoimmune diseases may increase Heart failure risk: JACC

Written By : Dr Satabdi Saha |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-07-15T08:45:14+05:30 | Updated On 15 July 2021 10:42 AM IST

In a recent research report, researchers have found that there is an association between heart failure status and use of specific DMARD therapy in SSc, SLE, and RA. "In all three conditions, there was high usage of mycophenolate treatment in patients with heart failure. This may reflect the practice patterns of clinicians for patients with more severe cardiac involvement." the research team further opined. The findings have been published in Journal of American College of Cardiology.

There is an increased risk of heart failure in patients with systemic autoimmune rheumatic diseases (SARDs), such as systemic sclerosis (SSc), systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA). We sought to assess the demographic, comorbidity, and medication associations with heart failure in these conditions.

This study design was a retrospective cohort study of adult patients with SSc, SLE, or RA at a large urban hospital system from 2000-2020. Demographic information, heart failure and comorbidity status, and disease-modifying antirheumatic drug (DMARD) usage data was extracted from electronic medical records. Clinically relevant DMARDs were selected for each SARD subgroup analysis. Multivariable logistic regression was performed to investigate the association between each DMARD exposure and heart failure status.

Results highlighted some key facts.

Of 86,491 patients, 5,558 had SSc, 20,704 had SLE, and 60,229 had RA. 20.3% of SSc, 14.1% of SLE, and 16.0% of RA patients had heart failure diagnoses.
Univariate analysis demonstrated that age, gender, race, history of ischemic heart disease, diabetes, and hypertension were significantly associated with heart failure in all three subgroups, while BMI was associated with heart failure in SLE and RA only (p < 0.001).
Mycophenolate use was significantly associated with heart failure in SSc (OR: 1.83; CI: 1.52-2.21; p < 0.001), SLE (OR: 1.38; CI: 1.20-1.59; p < 0.001), and RA patients (OR: 1.96; CI: 1.66-2.31; p < 0.001).
For RA, methotrexate (OR: 0.81; CI: 0.77-0.86; p < 0.001), TNF inhibitor (OR: 0.77; CI: 0.72 - 0.85; p < 0.001), and anakinra (OR: 2.20; CI: 1.27-3.74; p = 0.05) use were also associated with heart failure.

For full article follow the link: Zagouras A, Chatterjee S, Tang WH. Association between disease modifying antirheumatic drugs and heart failure in patients with systemic autoimmune diseases. Presented at: American College of Cardiology (ACC) Annual Meeting

Source: Journal of American College of Cardiology

Journal of the American College of Cardiologyheart failureDMARD therapyautoimmune disorders

Source : Journal of American College of Cardiology

Dr Satabdi Saha

Dr Satabdi Saha (BDS, MDS) is a practicing pediatric dentist with a keen interest in new medical researches and updates. She has completed her BDS from North Bengal Dental College ,Darjeeling. Then she went on to secure an ALL INDIA NEET PG rank and completed her MDS from the first dental college in the country – Dr R. Ahmed Dental College and Hospital. She is currently attached to The Marwari Relief Society Hospital as a consultant along with private practice of 2 years. She has published scientific papers in national and international journals. Her strong passion of sharing knowledge with the medical fraternity has motivated her to be a part of Medical Dialogues.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751