Objectives

The purpose of this study was to compare the risks of incident heart failure (HF) among a variety of chronic inflammatory diseases (CIDs) and to determine whether risks varied by severity of inflammation within each CID.

Background

Individuals with CIDs are at elevated risk for cardiovascular diseases, but data are limited regarding risk for HF.

Methods

An electronic health records database from a large urban medical system was examined, comparing individuals with CIDs with frequency-matched controls without CIDs, all of whom were receiving regular outpatient care. Rates of incident HF were determined by using the Kaplan-Meier method and subsequently used multivariate-adjusted proportional hazards models to compare HF risks for each CID. Exploratory analyses determined HF risks by proxy measurement of CID severity.

Results

Of 37,636 patients (n = 18,278 patients with CIDs; and n = 19,358 controls without CIDs) there were 960 incident HF cases over a median of 3.6 years. Risks for incident HF were significantly or borderline significantly elevated for patients with systemic sclerosis (hazard ratio [HR]: 7.26; 95% confidence interval [CI]: 5.72 to 9.21; p < 0.01), systemic lupus erythematosus (HR: 3.15; 95% CI: 2.41 to 4.11; p < 0.01), rheumatoid arthritis (HR: 1.39; 95% CI: 1.13 to 1.71; p < 0.01), and human immunodeficiency virus (HR: 1.28; 95% CI: 0.99 to 1.66; p = 0.06). There was no association between psoriasis or inflammatory bowel disease and incident HF, although patients with those CIDs with higher levels of C-reactive protein had higher risks for HF than controls.

Conclusions

Systemic sclerosis and systemic lupus erythematosus were associated with the highest risks of HF, followed by rheumatoid arthritis and HIV. Measurements of inflammation were associated with HF risk across different CIDs.

中文翻译：

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慢性炎症性疾病与突发性心力衰竭的差异关联。

目标

这项研究的目的是比较各种慢性炎症性疾病（CID）中发生心力衰竭（HF）的风险，并确定风险是否随每个CID中炎症的严重程度而变化。

背景

具有CID的个体患心血管疾病的风险较高，但有关HF风险的数据有限。

方法

检查了来自大型城市医疗系统的电子健康记录数据库，比较了具有CID且频率匹配控制且无CID的个人，所有这些人均接受定期门诊治疗。通过使用Kaplan-Meier方法确定HF的发病率，然后使用多元调整比例风险模型比较每个CID的HF风险。探索性分析通过对CID严重程度的代理测量来确定确定的HF风险。

结果

在37,636名患者中（n = 18,278名有CID的患者； n = 19,358名没有CID的对照），在960名中位发病者中位数为3.6年。系统性硬化症患者发生HF的风险显着或临界升高（危险比[HR]：7.26； 95％置信区间[CI]：5.72至9.21； p <0.01），系统性红斑狼疮（HR：3.15； 95） ％CI：2.41至4.11； p <0.01），类风湿关节炎（HR：1.39； 95％CI：1.13至1.71； p <0.01）和人免疫缺陷病毒（HR：1.28； 95％CI：0.99至1.66； p = 0.06）。牛皮癣或炎症性肠病与HF的发生没有相关性，尽管那些CID水平较高的C反应蛋白患者比HF患者的HF风险更高。

结论

系统性硬化症和系统性红斑狼疮与HF风险最高相关，其次是类风湿关节炎和HIV。炎症的测量结果与不同CID中的HF风险相关。