Monday, November 23, 2009

RA and Congestive Heart Failure

What is the risk of Congestive Heart Failure in patients with RA?

Researchers at the Mayo Clinic have observed that patients with RA have twice the risk of developing congestive heart failure as compared with persons without rheumatoid arthritis. The excess risk stayed elevated even after researchers adjusted for common cardiovascular risk factors (i.e., hypertension, smoking, diabetes) and ischemic heart disease. Most interesting is that the risk of congestive heart failure is higher in RA patients who are RF-positive than in those who are RF-seronegative. This increased risk may be present at the earliest stages of the disease and may occur in the absence of obvious cardiovascular risk factors or ischemic heart disease. See “The Risk of Congestive Heart Failure in Rheumatoid Arthritis: A Population-Based Study Over 46 Years.”

In a more recent study, the Mayo Clinic researchers found that RA patients with heart failure appear to have a more subtle presentation, with a lower frequency of typical heart failure symptoms and signs, as compared with non-RA patients with heart failure. Mortality in the first year following heart failure is also higher in RA patients. Their data suggests that new ways of screening for early left ventricular dysfunction in patients with RA should be investigated in order to optimize survival rates. See “The Presentation and Outcome of Heart Failure in Patients With Rheumatoid Arthritis Differs From That in the General Population.”

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Rheumatoid Arthritis and Congestive Heart Failure

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