AB0718 RISK OF HEART FAILURE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF COHORT STUDIES
Authors: P. Paramiraksa, M. Boonsiri, P. Patthamalai, A. Tansawet
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is reported to be associated with an increased risk of incident cardiovascular diseases (CVD) e.g. myocardial infarction, atrial fibrillation, and heart failure. Nevertheless, it remains unclear whether patients with RA have an increased risk of incident heart failure. Several systematic review and meta-analysis were conducted to estimate the risk of CVD in RA but did not include heart failure in the analysis. <h3>Objectives:</h3> Our study aims to determine the risk of incident heart failure in patients with RA. <h3>Methods:</h3> A systematic search of MEDLINE, Scopus, EMBASE, Cochrane Library, and medRxiv was independently performed by 2 reviewers to identify relevant studies from inception to January 2024. The search terms are modified and varied by each database. The eligible criteria are cohort studies reporting the risk of incident heart failure among populations with RA. Both reviewers independently assessed the study quality. Estimates were pooled using random-effects meta-analysis. <h3>Results:</h3> Five studies with Five cohorts (n = 923,840 participants) met the eligibility criteria. The pooled aHR in the meta-analysis revealed a significant association between RA and risk of incident heart failure (pooled aHR, 1.41; 95% CI, 1.25-1.58). No evidence of publication bias was observed. Quality assessments of the included studies were high. <h3>Conclusion:</h3> In conclusion, patients with RA were at an increased risk of developing heart failure. Risk of heart failure should be considered in the management of RA patients, especially in cases with baseline risk which may require screening for heart failure. Research exploring underlying mechanisms for the association of RA and incident heart failure is warranted. <h3>REFERENCES:</h3> [1] Prasada S, Rivera A, Nishtala A, Pawlowski AE, Sinha A, Bundy JD, et al. Differential Associations of chronic inflammatory diseases with incident heart failure. JACC: Heart Failure. 2020;8(6):489–98. doi:10.1016/j.jchf.2019.11.013 [2] Nicola PJ, Maradit-Kremers H, Roger VL, Jacobsen SJ, Crowson CS, Ballman KV, et al. The risk of congestive heart failure in rheumatoid arthritis: A population-based study over 46 years. Arthritis &amp;amp; Rheumatism. 2005;52(2):412–20. doi:10.1002/art.20855 [3] Mantel Ä, Holmqvist M, Andersson DC, Lund LH, Askling J. Association between rheumatoid arthritis and risk of ischemic and nonischemic heart failure. Journal of the American College of Cardiology. 2017;69(10):1275–85. doi:10.1016/j.jacc.2016.12.033 [4] Løgstrup BB, Ellingsen T, Pedersen AB, Kjærsgaard A, Bøtker H, Maeng M. Development of heart failure in patients with rheumatoid arthritis: A Danish population-based study. European Journal of Clinical Investigation. 2018;48(5). doi:10.1111/eci.12915 [5] Huang S, Cai T, Weber BN, He Z, Dahal KP, Hong C, et al. Association between inflammation, incident heart failure, and heart failure subtypes in patients with rheumatoid arthritis. Arthritis Care &amp;amp; Research. 2022;75(5):1036–45. doi:10.1002/acr.24804 [6] Burke, J. F., Sussman, J. B., Kent, D. M., &amp; Hayward, R. A. (2015). Three simple rules to ensure reasonably credible subgroup analyses. <i>BMJ</i>. https://doi.org/10.1136/bmj.h5651 [7] Stroup, D. F. (2000). Meta-analysis of observational studies in epidemiology&lt;subtitle&gt;A proposal for reporting&lt;/subtitle&gt;. <i>JAMA</i>, <i>283</i>(15), 2008. https://doi.org/10.1001/jama.283.15.2008 [8] Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The Prisma 2020 statement: An updated guideline for reporting systematic reviews. <i>BMJ</i>. https://doi.org/10.1136/bmj.n71 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>