From the, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
J Intern Med. 2021 Sep;290(3):704-714. doi: 10.1111/joim.13309. Epub 2021 Jun 3.
Mounting evidence suggests that dermatomyositis/polymyositis (DM/PM) are associated with increased risk of atherosclerotic events and venous thromboembolism. However, data on the association between DM/PM and other cardiac outcomes, especially heart failure (HF), are scarce.
To examine the long-term risk and prognosis associated with adverse cardiac outcomes in patients with DM/PM.
Using Danish administrative registries, we included all patients ≥18 years with newly diagnosed DM/PM (1996-2018). Risks of incident outcomes were compared with non-DM/PM controls from the background population (matched 1:4 by age, sex, and comorbidity). In a secondary analysis, we compared mortality following HF diagnosis between DM/PM patients with HF and non-DM/PM patients with HF (matched 1:4 by age and sex).
The study population included 936 DM/PM patients (median age 58.5 years, 59.0% women) and 3744 matched non-DM/PM controls. The median follow-up was 6.9 years. Absolute 10-year risks of incident outcomes for DM/PM patients vs matched controls were as follows: HF, 6.98% (CI, 5.16-9.16%) vs 4.58% (3.79-5.47%) (P = 0.002); atrial fibrillation, 10.17% (7.94-12.71%) vs 7.07% (6.09-8.15%) (P = 0.005); the composite of ICD implantation/ventricular arrhythmias/cardiac arrest, 1.99% (1.12-3.27%) vs 0.64% (0.40-0.98%) (P = 0.02); and all-cause mortality, 35.42% (31.64-39.21%) vs 16.57% (15.10-18.10%) (P < 0.0001). DM/PM with subsequent HF was associated with higher mortality compared with HF without DM/PM (adjusted hazard ratio 1.58 [CI, 1.01-2.47]).
Patients with DM/PM had a higher associated risk of HF and other adverse cardiac outcomes compared with matched controls. Among patients developing HF, a history of DM/PM was associated with higher mortality.
越来越多的证据表明，皮肌炎/多发性肌炎（DM/PM）与动脉粥样硬化事件和静脉血栓栓塞的风险增加有关。然而，关于 DM/PM 与其他心脏结局（尤其是心力衰竭[HF]）之间关联的数据却很少。
研究 DM/PM 患者不良心脏结局的长期风险和预后。
我们使用丹麦行政登记册，纳入了所有 18 岁及以上新诊断为 DM/PM（1996-2018 年）的患者。通过年龄、性别和合并症与背景人群（按 1:4 比例匹配）进行比较，评估了新发结局的风险。在二次分析中，我们比较了 DM/PM 合并 HF 患者与非 DM/PM 合并 HF 患者的 HF 诊断后死亡率（按年龄和性别 1:4 匹配）。
研究人群包括 936 名 DM/PM 患者（中位年龄 58.5 岁，59.0%为女性）和 3744 名匹配的非 DM/PM 对照组。中位随访时间为 6.9 年。与匹配对照组相比，DM/PM 患者的 10 年绝对新发结局风险如下：HF，6.98%（CI，5.16-9.16%）vs 4.58%（3.79-5.47%）（P=0.002）；心房颤动，10.17%（7.94-12.71%）vs 7.07%（6.09-8.15%）（P=0.005）；ICD 植入/室性心律失常/心脏骤停的复合结局，1.99%（1.12-3.27%）vs 0.64%（0.40-0.98%）（P=0.02）；全因死亡率，35.42%（31.64-39.21%）vs 16.57%（15.10-18.10%）（P<0.0001）。DM/PM 合并 HF 患者的死亡率高于无 DM/PM 合并 HF 患者（校正后的 HR 1.58 [CI，1.01-2.47]）。
与匹配对照组相比，DM/PM 患者发生 HF 和其他不良心脏结局的风险更高。在发生 HF 的患者中，DM/PM 病史与更高的死亡率相关。
