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Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2021 Feb 01; Vol. 140, pp. 39-46. Date of Electronic Publication: 2020 Nov 02. - Publication Year :
- 2021
-
Abstract
- Rheumatoid arthritis (RA) is the most common inflammatory arthritis and is associated with increased risk of cardiovascular events and mortality. Evidence regarding outcomes following PCI is limited. This study aimed to assess differences in outcomes following percutaneous coronary intervention (PCI) between patients with and without RA. The Melbourne Interventional Group PCI registry (2005 to 2018) was used to identify 756 patients with RA. Outcomes were compared with the remaining cohort (n = 38,579). Patients with RA were older, more often female, with higher rates of hypertension, previous stroke, peripheral vascular disease, obstructive sleep apnea, chronic lung disease, myocardial infarction, and renal impairment, whereas rates of dyslipidemia and current smoking were lower, all p <0.05. Lesions in patients with RA were more frequently complex (ACC/AHA type B2/C), requiring longer stents, with higher rates of no reflow, all p <0.05. Risk of long-term mortality, adjusted for potential confounders, was higher for patients with RA (hazard ratio 1.53, 95% confidence interval 1.30 to 1.80; median follow-up 5.0 years), whereas 30-day outcomes including mortality, major adverse cardiovascular events, bleeding, stroke, myocardial infarction, coronary artery bypass surgery, and target vessel revascularization were similar. In subgroup analysis, patients with RA and lower BMI (P <subscript>for interaction</subscript> < 0.001) and/or acute coronary syndromes (P <subscript>for interaction</subscript> = 0.05) had disproportionately higher risk of long-term mortality compared with patients without RA. In conclusion, patients with RA who underwent PCI had more co-morbidities and longer, complex coronary lesions. Risk of short-term adverse outcomes was similar, whereas risk of long-term mortality was higher, especially among patients with acute coronary syndromes and lower body mass index.<br /> (Copyright © 2020. Published by Elsevier Inc.)
- Subjects :
- Aged
Aged, 80 and over
Arthritis, Rheumatoid mortality
Coronary Artery Disease complications
Coronary Artery Disease mortality
Female
Follow-Up Studies
Humans
Male
Middle Aged
Propensity Score
Prospective Studies
Risk Factors
Survival Rate trends
Time Factors
Treatment Outcome
Victoria epidemiology
Arthritis, Rheumatoid complications
Coronary Artery Disease surgery
Percutaneous Coronary Intervention methods
Registries
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 140
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 33144158
- Full Text :
- https://doi.org/10.1016/j.amjcard.2020.10.048