Differential Associations of Chronic Inflammatory Diseases With Incident Heart Failure

Prasada, Sameer; Rivera, Adovich S.; Nishtala, Arvind; Pawlowski, Anna; Sinha, Arjun; Bundy, Joshua D; Chadha, Simran; Ahmad, Faraz; Khan, Sadiya S.; Achenbach, Chad; Palella, Frank J.; Ramsey‐Goldman, Rosalind; Lee, Yvonne; Silverberg, Jonathan I.; Taiwo, Babafemi; Shah, Sanjiv J.; Lloyd‐Jones, Donald M.; Feinstein, Matthew J.

doi:10.1016/j.jchf.2019.11.013

Cited by 51 publications

(52 citation statements)

References 57 publications

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“…The Northwestern Medicine Enterprise Data Warehouse (NMEDW) was used to create an electronic health record-based cohort of persons with CIDs and non-CID controls receiving regular outpatient care in the Northwestern Medicine (NM) system, which serves the large, diverse metropolitan area of Chicago, Illinois ( 9 ). As described previously, regular outpatient care was defined as at least 1 CID specialty and/or primary care outpatient visit at least once every 2 years between baseline (the first in-person outpatient encounter) and censoring dates (death, CHD, or most recent in-person outpatient encounter at least 1 year after baseline date if more than 2 years passed between outpatient visits) ( 9 ). Controls were defined as persons in care without CIDs and were 1:1 frequency-matched with the CID population on the combination of the following variables: age, sex, race, insurance status, baseline year, hypertension, and diabetes.…”

Section: Methodsmentioning

confidence: 99%

Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

Sinha

Rivera

Chadha

et al. 2021

Front. Cardiovasc. Med.

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Background: Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD). However, sparse data exist regarding relative CHD risks across CIDs.Objective: Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), systemic sclerosis (SSc), and inflammatory bowel disease (IBD).Methods: The cohort included patients with CIDs and controls without CID in an urban medical system from 2000 to 2019. Patients with CIDs were frequency-matched with non-CID controls on demographics, hypertension, and diabetes. CHD was defined as myocardial infarction (MI), ischemic heart disease, and/or coronary revascularization based on validated administrative codes. Multivariable-adjusted Cox models were used to determine the risk of incident CHD and MI for each CID relative to non-CID controls. In secondary analyses, we compared CHD risk by disease severity within each CID.Results: Of 17,049 patients included for analysis, 619 had incident CHD (202 MI) over an average of 4.4 years of follow-up. The multivariable-adjusted risk of CHD was significantly higher for SLE [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.2, 3.2] and SSc (HR 2.1, 95% CI 1.2, 3.9). Patients with SLE also had a significantly higher risk of MI (HR 3.6, 95% CI 1.9, 6.8). When CIDs were categorized by markers of disease severity (C-reactive protein for all CIDs except HIV, for which CD4 T cell count was used), greater disease severity was associated with higher CHD risk across CIDs.Conclusions: Patients with SLE and SSc have a higher risk of CHD. CHD risk with HIV, RA, psoriasis, and IBD may only be elevated in those with greater disease severity. Clinicians should personalize CHD risk and treatment based on type and severity of CID.

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Section: Methodsmentioning

confidence: 99%

Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

Sinha

Rivera

Chadha

et al. 2021

Front. Cardiovasc. Med.

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“…Similar to CIDs patients, cancer survivors are also at high risk of developing inflammatory/toxic CM. Pediatric patients who underwent chemotherapy with anthracycline and/or radiotherapy have 15 times higher HF incidence [49]. The proportion of chemotherapy-related cardiac dysfunction [50] is variable and depends upon initial CV risk factors, preexisting CV disease, as well as chemotherapy (may rise up to 27% upon treatment with HER2 -inhibitors) [51].…”

Section: Residual Myocardial Injury In Patients With Myocarditis and mentioning

confidence: 99%

COVID-19 myocarditis and prospective heart failure burden

Shchendrygina

Nagel

Püntmann

et al. 2020

Expert Review of Cardiovascular Therapy

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Introduction: COVID-19 is causing considerable morbidity and mortality worldwide. Serious respiratory complications aside, the heart is also frequently involved. The mechanisms and the extent of the myocardial injury, along with the short and long-term cardiovascular (CV) outcomes in COVID-19 survivors remain unclear. Areas covered: myocardial injury has been found in a considerable proportion of hospitalized COVID-19 patients and is associated with a worse prognosis. The late onset of CV complications with myocarditis-like changes revealed by CMR has been reported in COVID-19 survivors. Previous observational studies on viral myocarditis provide evidence of a significant incomplete recovery with residual dysfunction and remodeling of left ventricle. Incomplete recovery is thought to be the result of persistent myocardial inflammation due to a post-viral autoimmune response. Considering the significant inflammatory nature of COVID-19, COVID-19 survivors may be at risk of developing persistent residual myocardial injury, the sequelae of which are unclear. Expert commentary: COVID-19 is an emerging threat for the heart. The extent of CV injury, along with the short and long-term sequelae, requires further investigation. The early detection of residual myocardial changes in COVID-19 survivors is of utmost importance in order to identify those patients at risk of CV complication development.

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“…For instance, the systemic and vascular inflammatory damage from 30 years of poorly controlled RA is likely to differ considerably from the extent of cardiovascular damage and risk occurring in a person with recently diagnosed, mild RA. Indeed, our recent analysis of HF risk in different CIDs demonstrated increasing HF risk with increasing indicators of inflammatory burden across a number of CIDs 3 . However, even if this analysis has captured only a portion of those with chronic infectious and inflammatory conditions, we believe this still represents a substantial addition to present knowledge.…”

Section: Discussionmentioning

confidence: 99%

“…In chronic inflammatory conditions, development and wider use of immunomodulatory medications has likewise, in some cases, changed symptom burden and expected clinical course. Conversely, recent decades have seen an increasing body of evidence for the contribution of inflammation to cardiovascular disease (CVD) in both the general population and sub-populations with chronic infectious and inflammatory conditions 3 – 7 . We hypothesized that these changes in treatment of chronic infectious and inflammatory conditions may have implications on evolving risks for cardiovascular disease (CVD) and all-cause mortality.…”

Section: Introductionmentioning

confidence: 99%

Changes in proportionate cardiovascular mortality in patients with chronic infectious and inflammatory conditions in the United States, 1999–2018

Groenendyk

Rivera

Sinha

et al. 2021

Sci Rep

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Treatment options for several chronic infectious and inflammatory conditions have expanded in recent years. This may have implications for evolving competing risks for chronic inflammation-associated comorbidities, including cardiovascular diseases (CVDs). Yet sparse data exist on patterns over time in cardiovascular mortality for chronic infectious and inflammatory conditions. We used data from the Centers for Disease Control and Prevention 1999–2018 Multiple Causes of Death database to investigate patterns in CVD mortality from January 1, 1999 to December 31, 2018 in several infectious and inflammatory conditions. Specifically, we determined age-adjusted proportionate CVD mortality separately for patients with the following conditions (as well as the general population): hepatitis C virus (HCV), human immunodeficiency virus (HIV), inflammatory bowel diseases (IBD), psoriasis (PSO), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). Proportionate CVD mortality differed significantly in 1999 and 2018 for each condition compared with the general population (p < 0.0001). Proportionate CVD mortality decreased steadily in the general population (40.9 to 30.6%) but increased for patients with HCV (7.0 to 10.2%) and HIV (1.9 to 6.7%). For IBD, PSO, RA, and SLE, proportionate CVD mortality initially decreased followed by plateauing or increasing rates. Underlying disease-specific pathophysiologies, changes in natural history, and competing risks of chronic end-organ diseases contributing to these differences merit further study.

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Differential Associations of Chronic Inflammatory Diseases With Incident Heart Failure

Cited by 51 publications

References 57 publications

Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

COVID-19 myocarditis and prospective heart failure burden

Changes in proportionate cardiovascular mortality in patients with chronic infectious and inflammatory conditions in the United States, 1999–2018

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