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Prevalence, risk factors and proteomic bioprofiles associated with heart failure in rheumatoid arthritis: The RA-HF study.

Abstract：

BACKGROUND:Rheumatoid arthritis (RA) patients have high risk of heart failure (HF). AIMS:Identifying the risk factors and mechanistic pathways associated with HF in patients with RA. METHODS:Cohort study enrolling 355 RA patients. HF was defined according to the ESC criteria. 93 circulating protein-biomarkers (91CVDIIOlink®+troponin-T+c-reactive protein) were measured. Regression modeling (multivariate and multivariable) were built and network analyses were performed - based on the identified relevant protein biomarkers. RESULTS:115 (32.4%) patients fulfilled the ESC criteria for HF, but only 24 (6.8%) had a prior HF diagnosis. Patients with HF were older (67 vs. 55yr), had a longer RA duration (10 vs. 14yr), had more frequently diabetes, hypertension, obesity, dyslipidemia, atrial fibrillation, and ischemic arterial disease. Several protein-biomarkers remained independently associated with HF, the top (FDR1%) were adrenomedullin, placenta-growth-factor, TNF-receptor-11A, and angiotensin-converting-enzyme-2. The networks underlying the expression of these biomarkers pointed towards congestion, apoptosis, inflammation, immune system signaling and RAAS activation as central determinants of HF in RA. Similar HF-associated biomarker-pathways were externally found in patients without RA. Having RA plus HF increased the risk of cardiovascular events compared to RA patients without RF; adjusted-HR (95%CI)=2.37 (1.07-5.30), p=0.034 CONCLUSION: Age, cardiovascular risk factors, and RA duration increase the HF odds in patients with RA. Few RA patients had a correct prior HF diagnosis, but the presence of HF increased the patients` risk. RA patients with HF largely share the mechanistic pathways of HF patients without RA. Randomized HF trials should include patients with RA. CLINICALTRIALS. GOV ID:NCT03960515.

journal_name

Eur J Intern Med

journal_title

European journal of internal medicine

authors

Ferreira MB,Fonseca T,Costa R,Marinhoc A,Carvalho HC,Oliveira JC,Zannad F,Rossignol P,Gottenberg JE,Saraiva FA,Rodrigues P,Barros AS,Ferreira JP

doi

10.1016/j.ejim.2020.11.002

subject

Has Abstract

pub_date

2020-11-06 00:00:00

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(20)30412-X

pub_type

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Prevalence, risk factors and proteomic bioprofiles associated with heart failure in rheumatoid arthritis: The RA-HF study.