RA independently linked to poorer prognosis after myocardial
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Rheumatoid arthritis is independently linked to worse prognosis following myocardial infarction, with disease duration and corticosteroid use predicting mortality after myocardial infarction, according to data published in Rheumatology.

This study aimed to investigate the long-term outcomes of patients with rheumatoid arthritis (RA) after myocardial infarction (MI).

All-comer, real-life MI patients with RA (n=1614, mean age 74 years) were retrospectively compared to propensity score (1:5) matched MI patients without RA (n=8070) in a multicenter, nationwide, cohort register study in Finland. The impact of RA duration and the usage of corticosteroids and antirheumatic drugs on RA patients’ outcomes were also studied. The median follow-up was 7.3 years.

-- RA was associated with an increased 14-year mortality risk after MI compared to patients without RA (80.4% vs. 72.3%).

-- Patients with RA were at higher risk of new MI and revascularisation after discharge from index MI. Cumulative stroke rate after MI did not differ between RA and non-RA patients.

-- RA duration and corticosteroid usage before MI, but not use of methotrexate or biologic antirheumatic drugs, were independently associated with higher mortality and new MI.

-- A higher dosage of corticosteroids prior to MI was independently associated with higher long-term mortality and methotrexate usage with lower stroke rate.

-- Serological status of RA was not associated with outcomes.

Conclusively, RA is independently associated with poorer prognosis after MI. RA duration and corticosteroid usage and dosage were independent predictors of mortality after MI in RA. Special attention is needed for improvement of outcomes after MI in this vulnerable population.

Source: https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keab204/6154670