Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Semin Arthritis Rheum. 2020 Feb;50(1):25-29. doi: 10.1016/j.semarthrit.2019.07.006. Epub 2019 Jul 15.
To compare the frequency of and trends in hospitalizations after heart failure (HF) diagnosis in patients with and without rheumatoid arthritis (RA) during 1987-2015.
The study included a retrospectively identified population-based cohort of patients with incident HF and prior RA (age≥18 years, 1987 ACR criteria) and a cohort of incident HF patients without RA matched 3:1 on age, sex, and year of HF diagnosis. Hospitalizations at the time of HF diagnosis were excluded. All subjects were followed until death, migration, or 12/31/2015.
The study included 212 patients with RA (mean age at HF diagnosis 78.3 years; 68% female) and 636 non-RA patients (mean age at HF diagnosis 78.6 years; 68% female). The hospitalization rate after HF diagnosis was higher in RA vs non-RA (rate ratio [RR] 1.17; 95%CI 1.08-1.26). Hospitalization rates in both groups have been declining since 2005 and the difference between patients with and without RA may be decreasing after 2010. The magnitude of the increase was similar in both sexes and across all ages. Patients with RA were more likely to be hospitalized for non-cardiovascular causes (RR 1.26; 95%CI 1.14-1.39), but not for HF or other cardiovascular causes compared to non-RA patients.
The hospitalization rate following HF diagnosis was higher in RA versus non-RA patients regardless of sex and age. Increased hospitalization risk in patients with RA was driven by increased rates of non-cardiovascular hospitalization.
比较 1987 年至 2015 年间，心力衰竭（HF）诊断后住院的类风湿关节炎（RA）患者和无 RA 患者的频率和趋势。
该研究纳入了一个回顾性确定的基于人群的 HF 发病前 RA 患者队列（年龄≥18 岁，1987 年 ACR 标准）和一个 HF 发病前无 RA 的患者队列，按年龄、性别和 HF 诊断年份进行 3：1 匹配。HF 诊断时的住院情况被排除在外。所有患者均随访至死亡、迁移或 2015 年 12 月 31 日。
研究纳入了 212 例 RA 患者（HF 诊断时的平均年龄为 78.3 岁；68%为女性）和 636 例非 RA 患者（HF 诊断时的平均年龄为 78.6 岁；68%为女性）。HF 诊断后 RA 患者的住院率高于非 RA 患者（率比[RR]1.17；95%CI 1.08-1.26）。自 2005 年以来，两组的住院率均呈下降趋势，且自 2010 年以来，RA 患者和非 RA 患者之间的差异可能在缩小。这种增加的幅度在男女之间和所有年龄段都是相似的。与非 RA 患者相比，RA 患者更有可能因非心血管原因住院（RR 1.26；95%CI 1.14-1.39），但因 HF 或其他心血管原因住院的可能性较小。
HF 诊断后，RA 患者的住院率高于非 RA 患者，无论性别和年龄如何。RA 患者住院风险增加的原因是心血管以外住院率的增加。
