Rheumatoid arthritis patients are experiencing less coronary heart disease than in years past, but heart failure rates, however, remain unchanged, puzzling researchers.
Mayo Clinic researchers compared two patient cohorts, one diagnosed with rheumatoid arthritis between the years 1980 and 1994, and the other more recently between 1995 and 2007 in order to determine whether the risk of CHD and heart failure (HF) in rheumatoid arthritis (RA) patients has changed in recent years.
“There were a lot of notable differences between those cohorts,” says Cynthia S. Crowson of Mayo Clinic’s Division of Biomedical Statistics and Informatics. “Patients diagnosed more recently had lower sedimentation rates at diagnosis, were less likely to be smokers, and were more likely to be obese.” Crowson indicates that many recent patients may have had milder forms of RA due to more aggressive treatments.
Researchers also found a lower risk of CHD in these patients that were diagnosed more recently, but saw no changes in HF.
“We also noted that a lot of our HF is not proceeded by myocardial infarction in our RA patients, but another possibility is that there’s a lag in seeing a trend change for HF because it’s a later outcome in patients,” Crowson says.
These findings seem to indicate that HF could be occurring through a different mechanism and has lead to much speculation over what might be causing these changes; Crowson indicates that the Mayo Clinic will be examining this issue in future work.