Increased long‐term risk of heart failure and other adverse cardiac outcomes in dermatomyositis and polymyositis: Insights from a nationwide cohort. (3rd June 2021)

• Record Type: Journal Article
• Authors: Yafasova, A.; Diederichsen, L. P.; Schou, M.; Sun, G.; Torp‐Pedersen, C.; Gislason, G. H.; Fosbøl, E. L.; Køber, L.; Butt, J. H.
• Is Part Of: Journal of internal medicine. Volume 290:Number 3(2021)
• Page Start: 704
• Page End: 714
• Publication Date: 2021-06-03
• Subjects: atrial fibrillation -- autoimmune disease -- cohort study -- heart failure -- inflammation; Internal medicine -- Periodicals; Medicine -- Periodicals; 616
• DOI: 10.1111/joim.13309
• Languages: English
• ISSNs: 0954-6820

Abstract

Abstract: Background: Mounting evidence suggests that dermatomyositis/polymyositis (DM/PM) are associated with increased risk of atherosclerotic events and venous thromboembolism. However, data on the association between DM/PM and other cardiac outcomes, especially heart failure (HF), are scarce. Objectives: To examine the long‐term risk and prognosis associated with adverse cardiac outcomes in patients with DM/PM. Methods: Using Danish administrative registries, we included all patients ≥18 years with newly diagnosed DM/PM (1996–2018). Risks of incident outcomes were compared with non‐DM/PM controls from the background population (matched 1:4 by age, sex, and comorbidity). In a secondary analysis, we compared mortality following HF diagnosis between DM/PM patients with HF and non‐DM/PM patients with HF (matched 1:4 by age and sex). Results: The study population included 936 DM/PM patients (median age 58.5 years, 59.0% women) and 3744 matched non‐DM/PM controls. The median follow‐up was 6.9 years. Absolute 10‐year risks of incident outcomes for DM/PM patients vs matched controls were as follows: HF, 6.98% (CI, 5.16–9.16%) vs 4.58% (3.79–5.47%) ( P = 0.002); atrial fibrillation, 10.17% (7.94–12.71%) vs 7.07% (6.09–8.15%) ( P = 0.005); the composite of ICD implantation/ventricular arrhythmias/cardiac arrest, 1.99% (1.12–3.27%) vs 0.64% (0.40–0.98%) ( P = 0.02); and all‐cause mortality, 35.42% (31.64–39.21%) vs 16.57% (15.10–18.10%) ( P < 0.0001). DM/PM with subsequent HF was associated with higher mortality compared with HF without DM/PM (adjusted hazard ratio 1.58 [CI, 1.01–2.47]). Conclusion: Patients with DM/PM had a higher associated risk of HF and other adverse cardiac outcomes compared with matched controls. Among patients developing HF, a history of DM/PM was associated with higher mortality. Abstract :