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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Main Authors: Zuoxiang Wang, Junxing Lv, Xifeng Qian, Ziang Li, Zheng Yin, Can Wang, Sheng Zhao, Xiaojin Gao, Yongjian Wu
Format: Article
Language:English
Published: Wiley 2025-08-01
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.
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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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