Association Between Rheumatoid Arthritis and the Risk of Incident Degenerative Valvular Heart Disease: Evidence From a Prospective Cohort Study
Background Accumulating evidence indicates that degenerative valvular heart disease (VHD) and rheumatoid arthritis (RA) share overlapping risk factors and intersecting inflammatory processes; however, their interrelationship remains insufficiently explored. Methods Among 492 745 UK Biobank participa...
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Wiley
2025-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.125.042025 |
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| author | Zuoxiang Wang Junxing Lv Xifeng Qian Ziang Li Zheng Yin Can Wang Sheng Zhao Xiaojin Gao Yongjian Wu |
| author_facet | Zuoxiang Wang Junxing Lv Xifeng Qian Ziang Li Zheng Yin Can Wang Sheng Zhao Xiaojin Gao Yongjian Wu |
| author_sort | Zuoxiang Wang |
| collection | DOAJ |
| description | Background Accumulating evidence indicates that degenerative valvular heart disease (VHD) and rheumatoid arthritis (RA) share overlapping risk factors and intersecting inflammatory processes; however, their interrelationship remains insufficiently explored. Methods Among 492 745 UK Biobank participants without VHD at baseline, Cox proportional hazards models were conducted to assess the association between prevalent RA and new‐onset degenerative VHD, with sequential adjustments for demographic factors, lifestyle variables, and comorbidities. The end points of degenerative VHD in this study included 8 subtypes: aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid stenosis, tricuspid regurgitation, pulmonary stenosis, and pulmonary regurgitation. Results Among participants with RA (n=6673), 359 cases of degenerative VHD were recorded over a median follow‐up of 13.71 (interquartile range, 12.71–14.55) years, compared with 13 518 cases in those without RA (n=486 072) over a median follow‐up of 13.78 (interquartile range, 12.96–14.51) years. After full adjustment, RA was significantly associated with a higher risk of 3 types of new‐onset degenerative VHD: aortic stenosis (hazard ratio [HR], 1.64 [95% CI, 1.40–1.92]), aortic regurgitation (HR, 1.69 [95% CI, 1.34–2.13]), and mitral regurgitation (HR, 1.54 [95% CI, 1.32–1.81]), while no significant association was observed between RA and other degenerative VHD subtypes. Moreover, sex subgroup analyses revealed an interaction between sex and RA in the occurrence of aortic stenosis (P for interaction=0.02) and mitral regurgitation (P for interaction=0.04), indicating a higher risk in women. Conclusions The presence of RA indicated an elevated risk of new‐onset degenerative aortic stenosis, aortic regurgitation, and mitral regurgitation, which required further investigation and better disease management. |
| format | Article |
| id | doaj-art-11ea84efb7ed4369a2a1c4c63cb6a291 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-11ea84efb7ed4369a2a1c4c63cb6a2912025-08-20T07:24:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-08-01141610.1161/JAHA.125.042025Association Between Rheumatoid Arthritis and the Risk of Incident Degenerative Valvular Heart Disease: Evidence From a Prospective Cohort StudyZuoxiang Wang0Junxing Lv1Xifeng Qian2Ziang Li3Zheng Yin4Can Wang5Sheng Zhao6Xiaojin Gao7Yongjian Wu8Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College No. 167 Beilishi Road, Xicheng District Beijing 100037 ChinaBackground Accumulating evidence indicates that degenerative valvular heart disease (VHD) and rheumatoid arthritis (RA) share overlapping risk factors and intersecting inflammatory processes; however, their interrelationship remains insufficiently explored. Methods Among 492 745 UK Biobank participants without VHD at baseline, Cox proportional hazards models were conducted to assess the association between prevalent RA and new‐onset degenerative VHD, with sequential adjustments for demographic factors, lifestyle variables, and comorbidities. The end points of degenerative VHD in this study included 8 subtypes: aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid stenosis, tricuspid regurgitation, pulmonary stenosis, and pulmonary regurgitation. Results Among participants with RA (n=6673), 359 cases of degenerative VHD were recorded over a median follow‐up of 13.71 (interquartile range, 12.71–14.55) years, compared with 13 518 cases in those without RA (n=486 072) over a median follow‐up of 13.78 (interquartile range, 12.96–14.51) years. After full adjustment, RA was significantly associated with a higher risk of 3 types of new‐onset degenerative VHD: aortic stenosis (hazard ratio [HR], 1.64 [95% CI, 1.40–1.92]), aortic regurgitation (HR, 1.69 [95% CI, 1.34–2.13]), and mitral regurgitation (HR, 1.54 [95% CI, 1.32–1.81]), while no significant association was observed between RA and other degenerative VHD subtypes. Moreover, sex subgroup analyses revealed an interaction between sex and RA in the occurrence of aortic stenosis (P for interaction=0.02) and mitral regurgitation (P for interaction=0.04), indicating a higher risk in women. Conclusions The presence of RA indicated an elevated risk of new‐onset degenerative aortic stenosis, aortic regurgitation, and mitral regurgitation, which required further investigation and better disease management.https://www.ahajournals.org/doi/10.1161/JAHA.125.042025aortic regurgitationaortic stenosisdegenerative valvular heart diseaseinflammationmitral regurgitationrheumatoid arthritis |
| spellingShingle | Zuoxiang Wang Junxing Lv Xifeng Qian Ziang Li Zheng Yin Can Wang Sheng Zhao Xiaojin Gao Yongjian Wu Association Between Rheumatoid Arthritis and the Risk of Incident Degenerative Valvular Heart Disease: Evidence From a Prospective Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aortic regurgitation aortic stenosis degenerative valvular heart disease inflammation mitral regurgitation rheumatoid arthritis |
| title | Association Between Rheumatoid Arthritis and the Risk of Incident Degenerative Valvular Heart Disease: Evidence From a Prospective Cohort Study |
| title_full | Association Between Rheumatoid Arthritis and the Risk of Incident Degenerative Valvular Heart Disease: Evidence From a Prospective Cohort Study |
| title_fullStr | Association Between Rheumatoid Arthritis and the Risk of Incident Degenerative Valvular Heart Disease: Evidence From a Prospective Cohort Study |
| title_full_unstemmed | Association Between Rheumatoid Arthritis and the Risk of Incident Degenerative Valvular Heart Disease: Evidence From a Prospective Cohort Study |
| title_short | Association Between Rheumatoid Arthritis and the Risk of Incident Degenerative Valvular Heart Disease: Evidence From a Prospective Cohort Study |
| title_sort | association between rheumatoid arthritis and the risk of incident degenerative valvular heart disease evidence from a prospective cohort study |
| topic | aortic regurgitation aortic stenosis degenerative valvular heart disease inflammation mitral regurgitation rheumatoid arthritis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.125.042025 |
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