Aortic Stenosis Risk in RA Save

A large cohort study has shown that rheumatoid arthritis (RA) patients are at an increased risk of developing aortic stenosis (AS), undergoing aortic valve intervention, or AS-related death.

The risk of incident AS, aortic valve intervention, AS-related death, and risk factors for AS was assessed in 73,070 RA patients identified from the Veterans Health Administration (VHA) and Centers for Medicare & Medicaid Services (between 2000 to 2019) and compared with age/sex matched non RA controls (10 controls for every one RA patient).

RA patients were 88% male; with a mean age of 63 years. The AS incidence rate was 3.97 per 1000 person-years in RA patients compared with 2.45 per 1000 person-years in the control patients. RA was associated with an increased risk of composite AS (adjusted hazard ratio 1.48; 95% CI, 1.41-1.55), aortic valve intervention (aHR, 1.34; 95% CI, 1.22-1.48), and AS-related death (aHR, 1.26; 95% CI, 1.04-1.54).

IN an older male cohort, RA patients were at higher risk of developing AS and the subsequent risks of undergoing aortic valve intervention and suffering from AS-related death. Given the mortality of AS related disease, RA patients should be carefully screened for valvular heart disease.