Outcomes of acute cardiovascular events in rheumatoid arthritis and systemic lupus erythematosus: A population-based study

Chao Han Lai, Chao Han Lai, Chao Han Lai, Cheng Yang Hsieh, April Barnado, Li Ching Huang, Li Ching Huang, Sheau Chiann Chen, Sheau Chiann Chen, Liang Miin Tsai, Yu Shyr, Yu Shyr, Chung Yi Li

研究成果: Article

1 引文 斯高帕斯(Scopus)

摘要

Objectives: Patients with RA and SLE have an excess cardiovascular risk. We aimed to evaluate outcomes of acute cardiovascular events in these patients. Methods: Using a nationwide database of Taiwan, we identified adult patients who experienced first-time acute myocardial infarction (n = 191 008), intracranial haemorrhage (n = 169 923) and ischaemic stroke (n = 486 890) over a 13-year period. Odds ratios (ORs) of in-hospital mortality and hazard ratios (HRs) of overall mortality and adverse outcomes during long-term follow-up in relation to RA and SLE were estimated with adjustment for potential confounders. Results: In each cohort, 748, 410 and 1419 patients had established RA; 256, 292 and 622 patients had SLE. Among acute myocardial infarction patients, RA and SLE were associated with in-hospital mortality (RA: OR 1.61, 95% CI 1.33, 1.95; SLE: OR 2.31, 95% CI 1.62, 3.28) and overall mortality. Additionally, RA (HR 1.28, 95% CI 1.18, 1.38) and SLE (HR 1.46, 95% CI 1.27, 1.69) increased the risk of major adverse cardiac events. After intracranial haemorrhage, patients with RA and SLE had higher risks of in-hospital mortality (RA: OR 1.61, 95% CI 1.26, 2.06; SLE: OR 3.00, 95% CI 2.33, 3.86) and overall mortality. After ischaemic stroke, RA and SLE increased in-hospital mortality (RA: OR 1.45, 95% CI 1.15, 1.83; SLE: OR 2.18, 95% CI 1.57, 3.02), overall mortality and recurrent cerebrovascular events (RA: HR 1.10, 95% CI 1.002, 1.21; SLE: HR 1.31, 95% CI 1.14, 1.51), among which ischaemic stroke (HR 1.39, 95% CI 1.19, 1.62) was more likely to recur in SLE patients. Conclusion: Both RA and SLE are consistently associated with adverse outcomes following acute cardiovascular events, highlighting the necessity of integrated care for affected patients.

原文English
頁(從 - 到)1355-1363
頁數9
期刊Rheumatology (United Kingdom)
59
發行號6
DOIs
出版狀態Published - 2020 六月 1

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Pharmacology (medical)

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    Lai, C. H., Lai, C. H., Lai, C. H., Hsieh, C. Y., Barnado, A., Huang, L. C., Huang, L. C., Chen, S. C., Chen, S. C., Tsai, L. M., Shyr, Y., Shyr, Y., & Li, C. Y. (2020). Outcomes of acute cardiovascular events in rheumatoid arthritis and systemic lupus erythematosus: A population-based study. Rheumatology (United Kingdom), 59(6), 1355-1363. https://doi.org/10.1093/rheumatology/kez456