Sahil Koppikar1, Keith Colaco2, Paula Harvey1, Shadi Akhtari1, Vinod Chandran3, Dafna D Gladman3, Richard Cook4, Lihi Eder1. 1. University of Toronto and Women's College Hospital, Toronto, Ontario, Canada. 2. Women's College Hospital, Toronto, Ontario, Canada. 3. University of Toronto, Krembil Research Institute, Toronto Western Hospital, and University of Toronto, Toronto, Ontario, Canada. 4. University of Waterloo, Waterloo, Ontario, Canada.
Abstract
OBJECTIVE: To assess the incidence and risk factors for heart failure in patients with psoriatic disease and to describe their electrocardiographic and echocardiographic findings. METHODS: A cohort analysis was conducted involving patients with psoriatic disease followed prospectively from 1978 to 2018. Participants were assessed according to a standard protocol every 6 to 12 months. The primary outcome was the time to first event of heart failure, further classified into ischemic and nonischemic heart failure (secondary outcomes). The association between cardiovascular risk factors, measures of disease activity, and heart failure events was assessed using Cox proportional hazards regression. Electrocardiographic and echocardiographic findings associated with heart failure events were described. RESULTS: A total of 1,994 patients with psoriatic disease were analyzed, with 64 incident heart failure events (38 ischemic, 26 nonischemic). The incidence rate of first heart failure event was 2.85 per 1,000 patient-years. In all events, the most common electrocardiographic findings were atrial fibrillation (22%) and bundle branch blocks (29%). Echocardiogram revealed 37% reduced ejection fraction and 63% preserved ejection fraction. In multivariable analysis, independent risk factors for all heart failure events were ischemic heart disease, adjusted mean tender joint count, adjusted mean swollen joint count, adjusted mean erythrocyte sedimentation rate, adjusted mean C-reactive protein level, and physical function (by Health Assessment Questionnaire) (all P < 0.05). Minimal disease activity state was protective for all heart failure (P < 0.05). CONCLUSION: Increased risk of heart failure is associated with a combination of known cardiovascular risk factors and measures of disease activity, particularly in nonischemic heart failure. The effect of inflammation on heart failure may be partially independent of atherosclerotic disease.
OBJECTIVE: To assess the incidence and risk factors for heart failure in patients with psoriatic disease and to describe their electrocardiographic and echocardiographic findings. METHODS: A cohort analysis was conducted involving patients with psoriatic disease followed prospectively from 1978 to 2018. Participants were assessed according to a standard protocol every 6 to 12 months. The primary outcome was the time to first event of heart failure, further classified into ischemic and nonischemic heart failure (secondary outcomes). The association between cardiovascular risk factors, measures of disease activity, and heart failure events was assessed using Cox proportional hazards regression. Electrocardiographic and echocardiographic findings associated with heart failure events were described. RESULTS: A total of 1,994 patients with psoriatic disease were analyzed, with 64 incident heart failure events (38 ischemic, 26 nonischemic). The incidence rate of first heart failure event was 2.85 per 1,000 patient-years. In all events, the most common electrocardiographic findings were atrial fibrillation (22%) and bundle branch blocks (29%). Echocardiogram revealed 37% reduced ejection fraction and 63% preserved ejection fraction. In multivariable analysis, independent risk factors for all heart failure events were ischemic heart disease, adjusted mean tender joint count, adjusted mean swollen joint count, adjusted mean erythrocyte sedimentation rate, adjusted mean C-reactive protein level, and physical function (by Health Assessment Questionnaire) (all P < 0.05). Minimal disease activity state was protective for all heart failure (P < 0.05). CONCLUSION: Increased risk of heart failure is associated with a combination of known cardiovascular risk factors and measures of disease activity, particularly in nonischemic heart failure. The effect of inflammation on heart failure may be partially independent of atherosclerotic disease.
Authors: Wunan Zhou; Meron Teklu; Vy Bui; Grigory A Manyak; Promita Kapoor; Amit K Dey; Alexander V Sorokin; Nidhi Patel; Heather L Teague; Martin P Playford; Julie Erb-Alvarez; Justin A Rodante; Andrew Keel; Sujata M Shanbhag; Li-Yueh Hsu; David A Bluemke; Marcus Y Chen; Marcus Carlsson; Nehal N Mehta Journal: Am J Prev Cardiol Date: 2021-05-30
Authors: Keith Colaco; Ker-Ai Lee; Shadi Akhtari; Raz Winer; Paul Welsh; Naveed Sattar; Iain B McInnes; Vinod Chandran; Paula Harvey; Richard J Cook; Dafna D Gladman; Vincent Piguet; Lihi Eder Journal: Arthritis Rheumatol Date: 2022-05-16 Impact factor: 15.483
Authors: Thao H P Nguyen; Morten Wang Fagerland; Gia Deyab; Gunnbjørg Hjeltnes; Ivana Hollan; Mark W Feinberg; Gro Ø Eilertsen; Knut Mikkelsen; Stefan Agewall Journal: PLoS One Date: 2021-06-25 Impact factor: 3.240