Association of Systemic Sclerosis With Incident Clinically Evident Heart Failure

Objective Primary myocardial involvement is an important cause of death in systemic sclerosis (SSc). Subclinical diastolic/systolic heart dysfunction is recognized; however, whether this indicates a subsequent increased risk of clinically overt heart failure (HF) remains largely unknown. We aimed to...

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Veröffentlicht in:Arthritis care & research (2010) 2023-07, Vol.75 (7), p.1452-1461
Hauptverfasser: Lin, Chun‐Yu, Chen, Hung‐An, Chang, Tsang‐Wei, Hsu, Tsai‐Ching, Su, Yu‐Jih
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container_end_page 1461
container_issue 7
container_start_page 1452
container_title Arthritis care & research (2010)
container_volume 75
creator Lin, Chun‐Yu
Chen, Hung‐An
Chang, Tsang‐Wei
Hsu, Tsai‐Ching
Su, Yu‐Jih
description Objective Primary myocardial involvement is an important cause of death in systemic sclerosis (SSc). Subclinical diastolic/systolic heart dysfunction is recognized; however, whether this indicates a subsequent increased risk of clinically overt heart failure (HF) remains largely unknown. We aimed to investigate the risk of clinically overt HF in a large, unselected SSc cohort. Methods This matched, retrospective cohort study was conducted using a nationwide insurance database in Taiwan. Incident SSc patients with no history of HF were identified, and non‐SSc comparison groups were selected and matched to the SSc groups by age, sex, and cohort entry time. The cumulative HF incidence was estimated using the Kaplan‐Meier method. Multivariable Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) for HF hospitalization. Results A total of 1,830 SSc patients and 27,981 controls were identified. The cumulative incidence of hospitalized HF at 3, 5, and 10 years among patients with SSc were 3.5%, 5.3%, and 9.7%, respectively. Compared with non‐SSc individuals, SSc patients had an increased risk of HF (adjusted HR 3.26 [95% confidence interval (95% CI) 2.49–4.28]). Subgroup analyses revealed that the impact of SSc on the occurrence of HF was greater among patients ages
doi_str_mv 10.1002/acr.25016
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Subclinical diastolic/systolic heart dysfunction is recognized; however, whether this indicates a subsequent increased risk of clinically overt heart failure (HF) remains largely unknown. We aimed to investigate the risk of clinically overt HF in a large, unselected SSc cohort. Methods This matched, retrospective cohort study was conducted using a nationwide insurance database in Taiwan. Incident SSc patients with no history of HF were identified, and non‐SSc comparison groups were selected and matched to the SSc groups by age, sex, and cohort entry time. The cumulative HF incidence was estimated using the Kaplan‐Meier method. Multivariable Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) for HF hospitalization. Results A total of 1,830 SSc patients and 27,981 controls were identified. The cumulative incidence of hospitalized HF at 3, 5, and 10 years among patients with SSc were 3.5%, 5.3%, and 9.7%, respectively. Compared with non‐SSc individuals, SSc patients had an increased risk of HF (adjusted HR 3.26 [95% confidence interval (95% CI) 2.49–4.28]). Subgroup analyses revealed that the impact of SSc on the occurrence of HF was greater among patients ages &lt;50 years than those ages ≥50 years (HR 7.8 [95% CI 4.03–15.1] versus HR 2.78 [95% CI 2.06–3.76]). Conclusion SSc is associated with a markedly higher risk of clinically evident HF and not asymptomatic ventricular dysfunction alone. These findings provide real‐world evidence suggesting the use of appropriate screening strategies to detect these lethal complications early in SSc.</description><identifier>ISSN: 2151-464X</identifier><identifier>EISSN: 2151-4658</identifier><identifier>DOI: 10.1002/acr.25016</identifier><identifier>PMID: 36071607</identifier><language>eng</language><publisher>Boston, USA: Wiley Periodicals, Inc</publisher><subject>Congestive heart failure ; Heart diseases ; Heart failure ; Heart Failure - complications ; Heart Failure - diagnosis ; Heart Failure - epidemiology ; Humans ; Incidence ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Scleroderma ; Scleroderma, Systemic - complications ; Scleroderma, Systemic - diagnosis ; Scleroderma, Systemic - epidemiology ; Systemic sclerosis ; Ventricle</subject><ispartof>Arthritis care &amp; research (2010), 2023-07, Vol.75 (7), p.1452-1461</ispartof><rights>2022 American College of Rheumatology.</rights><rights>2023 American College of Rheumatology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-286ab19cc61e34866572edcf77111e9d556d955066d367165d3f9451750e83143</citedby><cites>FETCH-LOGICAL-c3536-286ab19cc61e34866572edcf77111e9d556d955066d367165d3f9451750e83143</cites><orcidid>0000-0002-2273-7877 ; 0000-0002-7274-3458</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Facr.25016$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Facr.25016$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36071607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Chun‐Yu</creatorcontrib><creatorcontrib>Chen, Hung‐An</creatorcontrib><creatorcontrib>Chang, Tsang‐Wei</creatorcontrib><creatorcontrib>Hsu, Tsai‐Ching</creatorcontrib><creatorcontrib>Su, Yu‐Jih</creatorcontrib><title>Association of Systemic Sclerosis With Incident Clinically Evident Heart Failure</title><title>Arthritis care &amp; research (2010)</title><addtitle>Arthritis Care Res (Hoboken)</addtitle><description>Objective Primary myocardial involvement is an important cause of death in systemic sclerosis (SSc). Subclinical diastolic/systolic heart dysfunction is recognized; however, whether this indicates a subsequent increased risk of clinically overt heart failure (HF) remains largely unknown. We aimed to investigate the risk of clinically overt HF in a large, unselected SSc cohort. Methods This matched, retrospective cohort study was conducted using a nationwide insurance database in Taiwan. Incident SSc patients with no history of HF were identified, and non‐SSc comparison groups were selected and matched to the SSc groups by age, sex, and cohort entry time. The cumulative HF incidence was estimated using the Kaplan‐Meier method. Multivariable Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) for HF hospitalization. Results A total of 1,830 SSc patients and 27,981 controls were identified. The cumulative incidence of hospitalized HF at 3, 5, and 10 years among patients with SSc were 3.5%, 5.3%, and 9.7%, respectively. Compared with non‐SSc individuals, SSc patients had an increased risk of HF (adjusted HR 3.26 [95% confidence interval (95% CI) 2.49–4.28]). Subgroup analyses revealed that the impact of SSc on the occurrence of HF was greater among patients ages &lt;50 years than those ages ≥50 years (HR 7.8 [95% CI 4.03–15.1] versus HR 2.78 [95% CI 2.06–3.76]). Conclusion SSc is associated with a markedly higher risk of clinically evident HF and not asymptomatic ventricular dysfunction alone. These findings provide real‐world evidence suggesting the use of appropriate screening strategies to detect these lethal complications early in SSc.</description><subject>Congestive heart failure</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - epidemiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Scleroderma</subject><subject>Scleroderma, Systemic - complications</subject><subject>Scleroderma, Systemic - diagnosis</subject><subject>Scleroderma, Systemic - epidemiology</subject><subject>Systemic sclerosis</subject><subject>Ventricle</subject><issn>2151-464X</issn><issn>2151-4658</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE9LwzAcQIMobswd_AJS8KKHbvnTpO1xlM0NBopT9BayNMWMtJ1Jq_TbG-3cQTAQEsLj8csD4BLBCYIQT4W0E0whYidgiBFFYcRocnq8R68DMHZuB_0iOElIeg4GhMEY-T0EDzPnaqlFo-sqqItg07lGlVoGG2mUrZ12wYtu3oJVJXWuqibIjK60FMZ0wfyjf1oqYZtgIbRprboAZ4UwTo0P5wg8L-ZP2TJc39-tstk6lIQSFuKEiS1KpWRIkShhjMZY5bKIY4SQSnNKWZ5SChnLCfOz0pwUaURRTKFKCIrICNz03r2t31vlGl5qJ5UxolJ16zj2oiTCiGCPXv9Bd3VrKz8dxwlOGYqJbzMCtz0l_bedVQXfW10K23EE-Xdp7kvzn9KevToY222p8iP529UD0x741EZ1_5v4LHvslV8zqIR0</recordid><startdate>202307</startdate><enddate>202307</enddate><creator>Lin, Chun‐Yu</creator><creator>Chen, Hung‐An</creator><creator>Chang, Tsang‐Wei</creator><creator>Hsu, Tsai‐Ching</creator><creator>Su, Yu‐Jih</creator><general>Wiley Periodicals, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2273-7877</orcidid><orcidid>https://orcid.org/0000-0002-7274-3458</orcidid></search><sort><creationdate>202307</creationdate><title>Association of Systemic Sclerosis With Incident Clinically Evident Heart Failure</title><author>Lin, Chun‐Yu ; Chen, Hung‐An ; Chang, Tsang‐Wei ; Hsu, Tsai‐Ching ; Su, Yu‐Jih</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-286ab19cc61e34866572edcf77111e9d556d955066d367165d3f9451750e83143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Congestive heart failure</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - epidemiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Scleroderma</topic><topic>Scleroderma, Systemic - complications</topic><topic>Scleroderma, Systemic - diagnosis</topic><topic>Scleroderma, Systemic - epidemiology</topic><topic>Systemic sclerosis</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Chun‐Yu</creatorcontrib><creatorcontrib>Chen, Hung‐An</creatorcontrib><creatorcontrib>Chang, Tsang‐Wei</creatorcontrib><creatorcontrib>Hsu, Tsai‐Ching</creatorcontrib><creatorcontrib>Su, Yu‐Jih</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis care &amp; research (2010)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Chun‐Yu</au><au>Chen, Hung‐An</au><au>Chang, Tsang‐Wei</au><au>Hsu, Tsai‐Ching</au><au>Su, Yu‐Jih</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Systemic Sclerosis With Incident Clinically Evident Heart Failure</atitle><jtitle>Arthritis care &amp; research (2010)</jtitle><addtitle>Arthritis Care Res (Hoboken)</addtitle><date>2023-07</date><risdate>2023</risdate><volume>75</volume><issue>7</issue><spage>1452</spage><epage>1461</epage><pages>1452-1461</pages><issn>2151-464X</issn><eissn>2151-4658</eissn><abstract>Objective Primary myocardial involvement is an important cause of death in systemic sclerosis (SSc). Subclinical diastolic/systolic heart dysfunction is recognized; however, whether this indicates a subsequent increased risk of clinically overt heart failure (HF) remains largely unknown. We aimed to investigate the risk of clinically overt HF in a large, unselected SSc cohort. Methods This matched, retrospective cohort study was conducted using a nationwide insurance database in Taiwan. Incident SSc patients with no history of HF were identified, and non‐SSc comparison groups were selected and matched to the SSc groups by age, sex, and cohort entry time. The cumulative HF incidence was estimated using the Kaplan‐Meier method. Multivariable Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) for HF hospitalization. Results A total of 1,830 SSc patients and 27,981 controls were identified. The cumulative incidence of hospitalized HF at 3, 5, and 10 years among patients with SSc were 3.5%, 5.3%, and 9.7%, respectively. Compared with non‐SSc individuals, SSc patients had an increased risk of HF (adjusted HR 3.26 [95% confidence interval (95% CI) 2.49–4.28]). Subgroup analyses revealed that the impact of SSc on the occurrence of HF was greater among patients ages &lt;50 years than those ages ≥50 years (HR 7.8 [95% CI 4.03–15.1] versus HR 2.78 [95% CI 2.06–3.76]). Conclusion SSc is associated with a markedly higher risk of clinically evident HF and not asymptomatic ventricular dysfunction alone. These findings provide real‐world evidence suggesting the use of appropriate screening strategies to detect these lethal complications early in SSc.</abstract><cop>Boston, USA</cop><pub>Wiley Periodicals, Inc</pub><pmid>36071607</pmid><doi>10.1002/acr.25016</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2273-7877</orcidid><orcidid>https://orcid.org/0000-0002-7274-3458</orcidid></addata></record>
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subjects Congestive heart failure
Heart diseases
Heart failure
Heart Failure - complications
Heart Failure - diagnosis
Heart Failure - epidemiology
Humans
Incidence
Proportional Hazards Models
Retrospective Studies
Risk Factors
Scleroderma
Scleroderma, Systemic - complications
Scleroderma, Systemic - diagnosis
Scleroderma, Systemic - epidemiology
Systemic sclerosis
Ventricle
title Association of Systemic Sclerosis With Incident Clinically Evident Heart Failure
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