RA, SLE linked to adverse acute cardiovascular outcomes
medwireNews: Patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) have a high risk for adverse outcomes following an acute cardiovascular event, according to a population-based study.
Chung-Yi Li (National Cheng Kung University, Tainan, Taiwan) and study co-authors hope that their research “may help rheumatologists, cardiologists and neurologists recognize the inherent risks associated with RA and SLE following [acute myocardial infarction], [intracranial hemorrhage] and ischaemic stroke.”
As reported in Rheumatology, 191,008 patients included in a nationwide database of hospitalizations in Taiwan had an acute myocardial infarction over a 13-year period; of these, 748 also had an RA diagnosis, while 256 had SLE.
Individuals with RA were 1.61 times more likely to die in hospital than individuals without autoimmune disorders, after adjustment for factors such as age, sex, and comorbidities, while those with SLE were 2.31 times more likely.
Additionally, following an acute myocardial infarction, patients with RA or SLE were a significant 1.28 and 1.46 times more likely to experience a major adverse cardiac event, respectively. This was defined as any occurrence of all-cause mortality, myocardial infarction, and revascularization.
The study authors observed a similar pattern for in-hospital mortality among 486,890 patients who had an ischemic stroke and 169,923 who had an intracranial hemorrhage.
Following an ischemic stroke, the risk was increased a significant 1.45- and 2.18-fold for patients who had RA (n=1419) or SLE (n=622), respectively, while the significant increase in risk after intracranial hemorrhage was a corresponding 1.61-fold and threefold for 410 patients with RA and 292 with SLE.
The presence of RA or SLE was also associated with a significantly increased risk for recurrent cerebrovascular disease after ischemic stroke, with adjusted hazard ratios (HRs) of 1.10 and 1.31, respectively, whereas there was no significant association between either rheumatologic condition and recurrent cerebrovascular events after an intracranial hemorrhage.
Furthermore, Li and colleagues report that the findings for overall mortality were similar to those for in-hospital mortality in all three cohorts.
And they conclude: “Both RA and SLE are consistently associated with adverse outcomes following acute cardiovascular events, highlighting the necessity of integrated care for affected patients.”
By Hannah Kitt
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