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14-09-2022 | Systemic sclerosis | News

Systemic sclerosis linked to increased risk for heart failure

Author: Claire Barnard

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medwireNews: People with systemic sclerosis (SSc) have an approximately threefold increased risk for clinically evident heart failure (HF) compared with the general population, suggest the results of a cohort study.

“These findings provide real-world evidence suggesting the use of appropriate screening strategies to detect these lethal complications early in SSc,” write Yu-Jih Su (Chang Gung University, Taoyuan, Taiwan) and colleagues in Arthritis Care & Research.

The team used Taiwan’s National Health Insurance database to compare rates of first time hospitalization for HF in 2000–2013 among 1830 people with SSc and 27,981 matched controls. These people were aged an average of 51 years and around three-quarters were women.

During an average follow-up of approximately 6 years, people with SSc had a significant 3.26-fold increased risk for HF hospitalization compared with controls after adjustment for comorbidities and medication use, at overall rates of 6.6% and 2.1%, respectively.

Su and team say that this elevated risk for hospitalized HF associated with SSc remained “relatively constant” during the study period, but the risk increase was “slightly higher” within the first year after SSc diagnosis relative to later periods.

Specifically, the cumulative rates of HF in the SSc and control groups were 1.3% versus 0.2% at 1 year, 3.5% versus 0.7% at 3 years, 5.3% versus 1.4% at 5 years, and 9.7% versus 3.1% at 10 years, resulting in hazard ratios (HRs) of 3.95, 3.66, 3.06, and 3.04, respectively.

The researchers also note that the association was “more pronounced” among younger compared with older people, with HRs of 7.80 in people younger than 50 years, compared with 2.78 among older individuals.

Taken together, these findings “bridge the gap between previous observations of subclinical heart dysfunction in SSc and clinically relevant HF,” write Su et al.

They caution that their study had a number of limitations, including a lack of information on the subtype of SSc, disease activity, and heart function assessments.

It was therefore not possible to assess “the impact of different SSc subtypes or SSc severity on HF incidence,” and “we could not be sure if the higher risk of hospitalized HF observed in patients with SSc was affected more by diastolic or systolic dysfunction,” they add.

Nevertheless, “[c]onsidering the high mortality risk following HF hospitalization, our novel findings suggest that clinicians involved in the care of SSc patients should pay attention to associated symptoms and signs of HF,” concludes the team.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

Arthritis Care Res 2022; doi:10.1002/acr.25016

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