Document Detail


Heart failure in rheumatoid arthritis: rates, predictors, and the effect of anti-tumor necrosis factor therapy.
MedLine Citation:
PMID:  14984815     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We sought to determine the frequency of heart failure in patients with rheumatoid arthritis, and to determine its predictors, particularly the use of anti-tumor necrosis factor (TNF) therapy. METHODS: Rheumatoid arthritis (n = 13,171) and osteoarthritis (n = 2568) patients were studied during a 2-year period ending in June 2002. The diagnosis of heart failure was based on self-report or review of medical records. Propensity scores were used to adjust for the risk of anti-TNF (infliximab and etanercept) prescription. RESULTS: Heart failure was more common among patients with rheumatoid arthritis (3.9% [n = 461]) than in those with osteoarthritis (2.3% [n = 87]), after adjusting for differences in demographic characteristics. Patients with rheumatoid arthritis had similar risk factors for heart failure (e.g., hypertension, prior myocardial infarction, diabetes, advanced age) as persons in population-based studies. Heart failure was significantly (P <0.05) less common in anti-TNF-treated patients (3.1% [180/5832]) than in the remaining patients (3.8% [281/7339]), even after adjusting for baseline differences. In the absence of pre-existing cardiovascular disease, the risk of heart failure was low (0.4% [24/6251]) and was not related to anti-TNF therapy. CONCLUSION: Our results suggest that rheumatoid arthritis increases the risk of heart failure, which may be ameliorated by anti-TNF therapies.
Authors:
Frederick Wolfe; Kaleb Michaud
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of medicine     Volume:  116     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-26     Completed Date:  2004-03-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  305-11     Citation Subset:  AIM; IM    
Affiliation:
Arthritis Research Center Foundation, University of Kansas School of Medicine, Wichita 67214, USA. fwolfe@arthritis-research.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Antibodies, Monoclonal / adverse effects,  therapeutic use*
Antirheumatic Agents / adverse effects,  therapeutic use
Arthritis, Rheumatoid / complications*,  drug therapy
Female
Heart Failure / chemically induced,  diagnosis,  etiology*
Humans
Immunoglobulin G / adverse effects,  therapeutic use*
Male
Middle Aged
Osteoarthritis / complications
Receptors, Tumor Necrosis Factor / therapeutic use*
Risk Factors
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antirheumatic Agents; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 185243-69-0/TNFR-Fc fusion protein
Comments/Corrections
Comment In:
Am J Med. 2004 Jun 15;116(12):854   [PMID:  15178504 ]
Am J Med. 2004 Nov 1;117(9):709; author reply 709   [PMID:  15501214 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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