Longterm outcomes and treatment after myocardial infarction in patients with rheumatoid arthritis

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Abstract

Objective. To investigate the risk profiles, treatment, and outcomes of patients with rheumatoid arthritis (RA) with myocardial infarction (MI) and matched MI patients without RA. Methods. We used a population-based cohort of Olmsted County, Minnesota, residents with MI from the period 1979-2009. We identified 77 patients who fulfilled the American College of Rheumatology 1987 criteria for RA and 154 MI patients without RA matched for age, sex, and calendar year. Data collection from medical records included RA and MI characteristics, antirheumatic and cardioprotective medications, reperfusion therapy, and outcomes (mortality, heart failure, and recurrent ischemia). Results. The mean age at MI was 72.4 years and 55% of patients were female in both cohorts. Cardiovascular risk factor profiles, MI characteristics, and treatment with reperfusion therapy or cardioprotective medications were similar in MI patients with and those without RA. Patients with RA experienced poorer longterm outcomes compared to patients without RA - for mortality: hazard ratio (HR) 1.47; 95% CI 1.04, 2.08; and for recurrent ischemia: HR 1.51; 95% CI 1.04, 2.18. Conclusion. MI patients with RA received similar treatment with reperfusion therapy and cardioprotective medications and had similar short-term outcomes compared to patients without RA. Patients with RA had poorer longterm outcomes. Despite similar treatment, MI patients with RA had worse longterm outcomes than MI patients without RA. The Journal of Rheumatology

Original languageEnglish (US)
Pages (from-to)605-610
Number of pages6
JournalJournal of Rheumatology
Volume40
Issue number5
DOIs
StatePublished - May 2013

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Rheumatoid Arthritis
Myocardial Infarction
Reperfusion
Therapeutics
Ischemia
Mortality
Rheumatology
Medical Records
Heart Failure

Keywords

  • Myocardial infarction
  • Rheumatoid arthritis
  • Treatment

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

@article{88e6120376ef489fba752b7fbc34dd71,
title = "Longterm outcomes and treatment after myocardial infarction in patients with rheumatoid arthritis",
abstract = "Objective. To investigate the risk profiles, treatment, and outcomes of patients with rheumatoid arthritis (RA) with myocardial infarction (MI) and matched MI patients without RA. Methods. We used a population-based cohort of Olmsted County, Minnesota, residents with MI from the period 1979-2009. We identified 77 patients who fulfilled the American College of Rheumatology 1987 criteria for RA and 154 MI patients without RA matched for age, sex, and calendar year. Data collection from medical records included RA and MI characteristics, antirheumatic and cardioprotective medications, reperfusion therapy, and outcomes (mortality, heart failure, and recurrent ischemia). Results. The mean age at MI was 72.4 years and 55{\%} of patients were female in both cohorts. Cardiovascular risk factor profiles, MI characteristics, and treatment with reperfusion therapy or cardioprotective medications were similar in MI patients with and those without RA. Patients with RA experienced poorer longterm outcomes compared to patients without RA - for mortality: hazard ratio (HR) 1.47; 95{\%} CI 1.04, 2.08; and for recurrent ischemia: HR 1.51; 95{\%} CI 1.04, 2.18. Conclusion. MI patients with RA received similar treatment with reperfusion therapy and cardioprotective medications and had similar short-term outcomes compared to patients without RA. Patients with RA had poorer longterm outcomes. Despite similar treatment, MI patients with RA had worse longterm outcomes than MI patients without RA. The Journal of Rheumatology",
keywords = "Myocardial infarction, Rheumatoid arthritis, Treatment",
author = "McCoy, {Sara S.} and Cynthia Crowson and {Maradit Kremers}, {Hilal D} and Therneau, {Terry M} and Roger, {Veronique Lee} and Matteson, {Eric Lawrence} and Gabriel, {Sherine E.}",
year = "2013",
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doi = "10.3899/jrheum.120941",
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T1 - Longterm outcomes and treatment after myocardial infarction in patients with rheumatoid arthritis

AU - McCoy, Sara S.

AU - Crowson, Cynthia

AU - Maradit Kremers, Hilal D

AU - Therneau, Terry M

AU - Roger, Veronique Lee

AU - Matteson, Eric Lawrence

AU - Gabriel, Sherine E.

PY - 2013/5

Y1 - 2013/5

N2 - Objective. To investigate the risk profiles, treatment, and outcomes of patients with rheumatoid arthritis (RA) with myocardial infarction (MI) and matched MI patients without RA. Methods. We used a population-based cohort of Olmsted County, Minnesota, residents with MI from the period 1979-2009. We identified 77 patients who fulfilled the American College of Rheumatology 1987 criteria for RA and 154 MI patients without RA matched for age, sex, and calendar year. Data collection from medical records included RA and MI characteristics, antirheumatic and cardioprotective medications, reperfusion therapy, and outcomes (mortality, heart failure, and recurrent ischemia). Results. The mean age at MI was 72.4 years and 55% of patients were female in both cohorts. Cardiovascular risk factor profiles, MI characteristics, and treatment with reperfusion therapy or cardioprotective medications were similar in MI patients with and those without RA. Patients with RA experienced poorer longterm outcomes compared to patients without RA - for mortality: hazard ratio (HR) 1.47; 95% CI 1.04, 2.08; and for recurrent ischemia: HR 1.51; 95% CI 1.04, 2.18. Conclusion. MI patients with RA received similar treatment with reperfusion therapy and cardioprotective medications and had similar short-term outcomes compared to patients without RA. Patients with RA had poorer longterm outcomes. Despite similar treatment, MI patients with RA had worse longterm outcomes than MI patients without RA. The Journal of Rheumatology

AB - Objective. To investigate the risk profiles, treatment, and outcomes of patients with rheumatoid arthritis (RA) with myocardial infarction (MI) and matched MI patients without RA. Methods. We used a population-based cohort of Olmsted County, Minnesota, residents with MI from the period 1979-2009. We identified 77 patients who fulfilled the American College of Rheumatology 1987 criteria for RA and 154 MI patients without RA matched for age, sex, and calendar year. Data collection from medical records included RA and MI characteristics, antirheumatic and cardioprotective medications, reperfusion therapy, and outcomes (mortality, heart failure, and recurrent ischemia). Results. The mean age at MI was 72.4 years and 55% of patients were female in both cohorts. Cardiovascular risk factor profiles, MI characteristics, and treatment with reperfusion therapy or cardioprotective medications were similar in MI patients with and those without RA. Patients with RA experienced poorer longterm outcomes compared to patients without RA - for mortality: hazard ratio (HR) 1.47; 95% CI 1.04, 2.08; and for recurrent ischemia: HR 1.51; 95% CI 1.04, 2.18. Conclusion. MI patients with RA received similar treatment with reperfusion therapy and cardioprotective medications and had similar short-term outcomes compared to patients without RA. Patients with RA had poorer longterm outcomes. Despite similar treatment, MI patients with RA had worse longterm outcomes than MI patients without RA. The Journal of Rheumatology

KW - Myocardial infarction

KW - Rheumatoid arthritis

KW - Treatment

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