Incidence, prevalence, and characteristics of heart failure among patients with multiple sclerosis: A systematic review and meta-analysis

•The overall prevalence of HF was 1% among MS patients.•The pooled odds ratio estimate for HF was 1.29, indicating that although MS increased the odds of HF, this increase was not statistically significant.•This highlights the need for clinicians to pay more attention to the risk of HF in PwMS. Multiple sclerosis (MS) is the most common neurological autoimmune disease. Although it primarily harms the central nervous system, other organs are liable to be affected by it as well. There is a growing body of evidence suggesting that heart failure should be considered as a potential suspect for cardiac dysfunction and insufficiency among MS patients. As such, we designed this systematic review and meta-analysis to elaborate more on the incidence, prevalence, and characteristics of HF among MS patients. We conducted a systematic computerized search using four data banks: PubMed (MEDLINE), Scopus, web of science, and Embase (via Elsevier). The literature search found 930 articles. After eliminating duplicates, 695 articles remained, from which 42 articles were assessed for inclusion eligibility, and eventually 8 full-text articles were included in the final data extraction table. The overall prevalence of heart failure was 1% (95% CI: 0.6%–1.5%), which ranged from 0.6% observed in UK to 1.8% for Taiwan study. The overall incidence of heart failure was also 0.7% (95% CI: 0.4%–1.2%), ranging from 0.2% observed in UK to 1.4% in USA. The pooled odds ratio for the association between heart failure and multiple sclerosis calculated based on 4 studies, using random effect model was 1.29 (95% CI: 0.74–2.26; I2=82.5%), but not significant. In conclusion, this study demonstrates that patients with MS are at an elevated risk of developing heart failure compared to the general population, which highlights the importance of regular and thorough checkups in PwMS in an effort to better detect any cardiovascular abnormality, dysfunction, or disease as soon as possible to help improve the prognosis.