Diastolic Dysfunction in Rheumatoid Arthritis Save

Poor cardiovascular outcomes have been linked to inflammation and rheumatoid arthritis (RA). This includes higher rates of MI and heart failure (HF).

Researchers from Germany have studied their cohort of 157 RA patients and found the prevalence of HF in patients with RA (24%) was significantly greater than the control sample (6%, p = 0.001). Diastolic HF was the dominant type (23% vs 6%), and clinical symptoms alone were of low diagnostic value.

Diastolic dysfunction was identified in 59% of patients with RA compared to 39% of control participants, and women comprised a higher proportion of patients with HF. Independent risk factors for HF included the active RA by DAS28 ≥ 2.6 (OR 3.4, 95% CI 1.3–9.8), ESR > 16 mm/hr (OR 5.4, 95% CI 2.1–16), C-reactive protein > 10 mg/l (OR 2.6, 95% CI 0.8–8.0) and RA disease duration > 10 years (OR 2.6, 95% CI 1.2–5.8).

The prevalence of HF was equally seen in those receivine conventional DMARDs  (25%), tumor necrosis factor inhibitors (22%), other biological DMARDs (27%). (Citation source http://buff.ly/1ijt3f6)

Clinical signs of HF were seen in 62% of patients, but were not predictive of heart failure in many as the diagnosis of HF was made in only 40% of patients. N-terminal pro B-type natriuretic peptide (NT-proBNP) had better predictive value (PPV 78%) RA patients than controls.