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 |
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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 |
format | Article |
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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 <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 & 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 & 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 <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 & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis care & 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 & 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 <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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