Patients with systemic autoimmune rheumatic diseases (SARDs), like systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and rheumatoid arthritis (RA), are at an elevated risk of heart failure, found a study declared in the Journal of American College of Cardiology. The influence of comorbidities, demographic factors and medications on heart failure was intended to be evaluated by this study.


Adult patients with SARDs like SLE, SSc, or RA were included in a retrospective cohort study. Patient data between 2000 and 2020 was collected for the investigation. The electronic medical record was used to gather disease-modifying antirheumatic drug (DMARD) usage details, comorbidity status, demographics and incidence of heart failure. The link between DMARD exposure and heart failure was examined by performing multivariable logistic regression.


The study enrolled 86,491 patients, of which as many as 60,229 had RA and 20,740 had SLE. Only 5,558 presented with SSc.

Heart failure was diagnosed in 16% RA and 14.1% SLE patients.

By univariate analysis, all the three subgroups exhibited significant association of the following factors with heart failure:

  • Race

  • Gender

  • Age

  • Diabetes

  • Ischemic heart disease

  • Hypertension

Whereas only RA and SLE demonstrated a link of BMI with heart failure, p < 0.001.

A significant association was noted between the use of mycophenolate and the incidence of heart failure.

  • RA: Odds ratio (OR): 1.96; Confidence interval (CI): 1.66-2.31; p < 0.001

  • SLE: OR: 1.38; CI: 1.20-1.59; p < 0.001

  • SSc (OR: 1.83; CI: 1.52-2.21; p < 0.001


In RA patients, the use of TNF inhibitor, methotrexate and anakinra for treatment was also observed to increase the risk of heart failure.

  • TNF inhibitor: OR: 0.77; CI: 0.72 - 0.85; p < 0.001

  • Methotrexate: OR: 0.81; CI: 0.77-0.86; p < 0.001

  • Anakinra: OR: 2.20; CI: 1.27-3.74; p = 0.05


The usage of mycophenolate for treating RA, SLE and SSc patients was linked with the elevated risks of incidence of heart failure.



Disease Condition,Therapeutic Modality,Heart Failure,Pharmacotherutics,TPHT_others