Heart failure death rates rising again after decade of decline
Patients with rheumatoid arthritis (RA) have an increased incidence of diastolic dysfunction, which may further raise their already high risk for congestive heart failure, a meta-analysis suggested.
Patients with RA have double the incidence of heart failure compared with the larger population, and this finding has prompted interest in determining the origins of heart failure in these patients.
Almost one-fourth of patients hospitalized for heart failure had a history of cocaine use as a potential contributing factor, a retrospective chart review showed.
Heart failure death occurred two to three times more often in people with vitamin D insufficiency or deficiency compared with those who had normal levels of the vitamin, according to data from a government survey.
The researchers identified 190 pg/mL as the NT-proBNP threshold for increased risk. Among study participants with baseline levels less than 190 pg/mL, an increase greater than 25% to a level above 190 pg/mL had a twofold increased risk of heart failure (HR 2.13, 95% CI 1.68 to 2.71) and cardiovascular death (HR 1.91, 95% CI 1.43 to 2.53) compared with participants whose NT-proBNP levels remained below 190 pg/mL.
Among study participants with elevated baseline NT-proBNP levels, an increase greater than 25% also doubled the risk of heart failure (HR 2.06, 95% CI 1.56 to 2.72) and cardiovascular disease (HR 1.88, 95% CI 1.37 to 2.57).
Note this was an observational study.
Take Home Lesson:
Consider simply adding the usual recommended debits for CHF to the DM rate.
After all, the HF risk is doubled but not the mortality. And critics of this study question its statistical validity.