Heart failure risk in systemic lupus erythematosus compared to diabetes mellitus and general medicaid patients
| Autor: | Medha Barbhaiya, Michael A. Fischer, Brendan M. Everett, Hongshu Guan, Sarah K. Chen, Kazuki Yoshida, Karen H. Costenbader, Candace H. Feldman |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population Risk Assessment Article Young Adult Matched cohort Rheumatology Risk Factors Internal medicine Diabetes mellitus Diabetes Mellitus medicine Humans Lupus Erythematosus Systemic Myocardial infarction skin and connective tissue diseases education Aged Retrospective Studies Heart Failure education.field_of_study Medicaid business.industry Incidence Incidence (epidemiology) Hazard ratio Middle Aged medicine.disease United States Anesthesiology and Pain Medicine Heart failure Female business |
| Zdroj: | Semin Arthritis Rheum |
| ISSN: | 0049-0172 |
| Popis: | Background Patients with systemic lupus erythematosus (SLE) have a similar risk of myocardial infarction as those with diabetes mellitus (DM). Whether the risk of heart failure (HF) in SLE is similar to the elevated risk in DM is unknown. We sought to estimate the rates and risks for HF hospitalization among US Medicaid patients with SLE and to compare them to those for DM and the general Medicaid population. Methods Using U.S. Medicaid data from 2007–2010, we identified patients with SLE or DM, and a matched cohort from the general Medicaid population and calculated incidence rates (IR), incidence rate ratios (IRR) and adjusted hazard ratios (HR) of a first HF hospitalization. Results We identified 37,902 SLE (93% female, mean age 40.1 ± 12.1), 76,657 DM (93% female, mean age 40.0 ± 12.1), and 158,695 general Medicaid patients (93% female, mean age 40.2 ± 12.1). The IR per 1000-person years was 6.9 (95% CI 6.3–7.5) for SLE, 6.6 (95% CI 6.2–7.0) for DM, and 1.6 (95% CI 1.5–1.8) for general Medicaid patients. The highest IRR compared to general Medicaid was seen among SLE patients in age group 18–39 (14.7, 95% CI 13.9–15.5). Multivariable-adjusted HRs for HF compared to general Medicaid population were similar for SLE (2.7, 95% CI 2.3–3.1) and DM (3.0, 95% CI 2.6–3.4). Conclusion The incidence of HF among SLE patients was 2.7-fold higher than general Medicaid patients, and similar to DM. Further investigation into the biologic mechanism of HF among SLE compared to non-SLE and DM patients may shed light on the findings of this study. |
| Databáze: | OpenAIRE |
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