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Are Cardiac Complications Common in Patients With RA?

Publish date:

There is a significant trend of cardiovascular (CV) complications in patients with rheumatoid arthritis (RA), a new study found. Researchers used National Inpatient Sample data from 2005-2014 to identify admissions with the diagnosis of RA and identified who also had associated CV complications. They found:

  • A statistically significant increasing trend of acute myocardial infarction (AMI), congestive heart failure (CHF), and atrial fibrillation (AF) was found.
  • Independent predictors of mortality in RA patients with AMI were age, COPD, cerebrovascular disease, renal disease, and alcohol abuse.
  • Independent predictors of mortality in RA patients with CHF were age, COPD, cerebrovascular disease, and renal disease.
  • Independent predictors of mortality in RA patients with AF were age, race, peripheral arterial disease, cerebrovascular disease, and renal disease.
  • Mortality trends increased significantly in the CHF and AF groups during the study period.

Citation:

Bandyopadhyay D, et al. Trends of cardiac complications in patients with rheumatoid arthritis: Analysis of the United States National Inpatient Sample; 2005-2014. [Published online ahead of print August 23, 2019]. Curr Probl Cardiol. doi: 10.1016/j.cpcardiol.2019.100455.

Commentary:

The association of RA with cardiovascular complications such as heart attacks, high cholesterol, and atherosclerosis has received much recent attention, such that RA is considered an extra cardiovascular risk factor. This study on inpatient data from 2005-2014 is of interest because of the finding that there is an increasing trend of acute myocardial infarction, congestive heart failure (CHF), and atrial fibrillation (AF), as well as increased mortality due to CHF and AF, suggesting that this attention is not simply due to increased recognition, but to increased prevalence. That these trends are increasing despite the availability of a variety of aggressive RA medications is also of note, and may mean that reducing RA disease overall is not sufficient to prevent its cardiovascular complications. —Arundathi Jayatilleke, MD

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