Prevalence, risk factors and proteomic bioprofiles associated with heart failure in rheumatoid arthritis: The RA-HF study

• Type: Article in International Scientific Journal
• Date: 2021

Authors

Ferreira, MB (Author) Other; Fonseca, T (Author) Other; Costa, R (Author) Other; Marinhoc, A (Author) Other; Carvalho, HC (Author) Other; Oliveira, JC (Author) Other; Zannad, F (Author) Other; Rossignol, P (Author) Other; Gottenberg, JE (Author) Other; Saraiva, FA (Author) Other; Rodrigues, P (Author) Other; Barros, AS (Author) FMUP; Ferreira, JP (Author) FMUP

Journal

Title: European Journal of Internal Medicine

Vol. 85

Pages: 41-49

ISSN: 0953-6205

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 15 Citations

Scopus - 16 Citations

Other information

Authenticus ID: P-00S-ZKS

DOI: 10.1016/j.ejim.2020.11.002

Abstract (EN): Background: Rheumatoid arthritis (RA) patients have high risk of heart failure (HF). Aims: Identifying the risk factors and mechanistic pathways associated with HF in patients with RA. Methods: Cohort study enrolling 355 RA patients. HF was defined according to the ESC criteria. 93 circulating protein-biomarkers (91CVDIIOlink (R)+troponin-T+c-reactive protein) were measured. Regression modeling (multivariate and multivariable) were built and network analyses were performed based on the identified relevant protein biomarkers. Results: 115 (32.4%) patients fulfilled the ESC criteria for HF, but only 24 (6.8%) had a prior HF diagnosis. Patients with HF were older (67 vs. 55yr), had a longer RA duration (10 vs. 14yr), had more frequently diabetes, hypertension, obesity, dyslipidemia, atrial fibrillation, and ischemic arterial disease. Several protein-biomarkers remained independently associated with HF, the top (FDR1%) were adrenomedullin, placenta-growth-factor, TNF-receptor-11A, and angiotensin-converting-enzyme-2. The networks underlying the expression of these biomarkers pointed towards congestion, apoptosis, inflammation, immune system signaling and RAAS activation as central determinants of HF in RA. Similar HF-associated biomarker-pathways were externally found in patients without RA. Having RA plus HF increased the risk of cardiovascular events compared to RA patients without RF; adjusted-HR (95%CI)=2.37 (1.07-5.30), p=0.034 Conclusion: Age, cardiovascular risk factors, and RA duration increase the HF odds in patients with RA. Few RA patients had a correct prior HF diagnosis, but the presence of HF increased the patients' risk. RA patients with HF largely share the mechanistic pathways of HF patients without RA. Randomized HF trials should include patients with RA.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9