Author + information
- Chang Kima,b,
- Hussain Khalida,b,
- Arun Iyera,b,
- Toral Patela,b,
- Sadeer Al-Kindia,b and
- Guilherme Oliveiraa,b
Background: Systemic sclerosis (SSc; scleroderma) is a rare, progressive fibrotic disease which frequently leads to cardiac, pulmonary, and renal dysfunction. Despite shared risk factors, the epidemiology of heart failure (HF) in SSc remains ill-defined. We sought to investigate the risk of HF in a large, real-world SSc cohort.
Methods: Using a multi-institutional database (Explorys Inc, Cleveland, OH), we examined matched cohorts between October 2006 and September 2016 to explore the association between SSc and HF via demographic and multiple logistic regression analyses.
Results: We identified 17,510 patients with SSc and 10,826,520 age- and gender-matched controls. Annual incidence of HF was significantly higher in SSc compared to controls (1.18% vs. 0.28%, relative risk (RR): 4.17 [95% CI: 4.00-4.34]). While HF incidence increased with advancing age, there was a distinct inverse relationship with RR (Figure). In multivariable analysis, SSc was a significant predictor of HF (adjusted odds ratio: 1.76 [1.56-2.00], p<0.001), independent of age, gender, coronary artery disease, myocardial infarction, hypertension, valvular disease, chronic kidney disease (CKD), pulmonary hypertension (PHTN), and interstitial lung disease, though its effect was significantly mediated through CKD and PHTN (p for interaction <0.001).
Conclusions: Risk of HF is increased in patients with SSc, with higher RR in younger patients. SSc appears to be a significant and independent risk factor for HF.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Heart Failure: Evaluating Strategies to Prevent Readmissions
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1163-293
- 2017 American College of Cardiology Foundation