CV risk factors, HF increased in patients with polymyositis, dermatomyositis

ORLANDO, Fla. — Marked increases in CV risk factors and HF incidence were common in patients with polymyositis and dermatomyositis, according to a poster presentation from the Heart Failure Society of America Scientific Assembly.

“Despite the apparent increase in traditional CV risk factors in this population, the relative impact of these factors on the development of HF, in the setting of chronic inflammation in [polymyositis and dermatomyositis], remains unknown,” researchers wrote.

The researchers conducted a retrospective analysis of 48,502,820 patients with in a large, multi-institutional database to investigate the CV risk profile and risk for HF in patients with polymyositis and dermatomyositis.

The study also used the Explorys platform to provide aggregated electronic medical records from outpatients and inpatients from 26 integrated healthcare systems across the U.S. between 1999 and 2016.

Among the cohort, 5,980 (0.012%) had polymyositis and 10,420 (0.021%) had dermatomyositis.

HF incidence was significantly increased for those with either condition (polymyositis, 4.68%; dermatomyositis, 6.43%; controls, 0.54%), and the absolute and relative risks for HF increased as individuals aged, the researchers wrote.

While there were few significant sex differences in HF risk, inflammatory myopathies were more common in women, they wrote.

CV risk factors were more common in patients with inflammatory myopathies vs. those without them. The risk factors included hypertension (66.8% vs. 16.7%), diabetes (45.9% vs. 6.5%), smoking (13.7% vs. 3.2%), dyslipidemia (55.9% vs. 13.5%), obesity (24.7% vs. 5.2%) and CAD (25.6% vs. 4.4%).

Valvular disease (13.9% vs. 2.4%), conduction system disease (33.4% vs. 6.6%), myocarditis (0.49% vs. 0.02%), and pulmonary hypertension (4.2% vs. 0.2%) were also more prevalent in those with an inflammatory myopathy, according to the researchers.

In multivariable analysis, inflammatory myopathy was an independent risk factor for HF (adjusted OR = 2.22; 95% CI, 2.08–2.37), according to the researchers, who noted that the effect size of inflammatory myopathy on risk for HF was greater than that of advanced age (OR = 1.93; 95% CI: 1.92–1.95), diabetes (OR = 1.62; 95% CI: 1.60–1.63), smoking (OR = 1.45; 95% CI, 1.43–1.47) and dyslipidemia (OR = 1.86; 95% CI, 1.84–1.88); similar to that of obesity (OR = 2.23; 95% CI: 2.21–2.25); and smaller than that of hypertension (OR = 9.2; 95% CI, 9.06–9.35) and CAD (OR = 4.59; 95% CI, 4.54–4.63).

“Control of both disease activity and CV risk factors may be important in the management of HF risk in this population,” the researchers wrote. – by Dave Quaile

Reference:

Kim CH, et al. Poster 049. Presented at: Heart Failure Society of America Scientific Assembly; Sept. 17-20, 2016; Orlando, Fla.

Disclosure: The researchers report no relevant financial disclosures.