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MI Outcomes May Be Worse in Patients With Rheumatic IMID

MI outcomes poorer in Medicare beneficiaries with versus without rheumatic immune-mediated inflammatory disease

FRIDAY, Sept. 23, 2022 (HealthDay News) — The risks for mortality, heart failure, and recurrent myocardial infarction (MI) and the need for coronary reintervention are increased for patients with MI and rheumatic immune-mediated inflammatory diseases (IMIDs), according to a study published in the Sept. 20 issue of the Journal of the American Heart Association.

Heba Wassif, M.D., M.P.H., from the Cleveland Clinic, and colleagues examined the long-term prognosis of acute coronary syndromes among Medicare beneficiaries admitted with a primary diagnosis of MI from 2014 to 2019. In a one-to-three propensity score-matched analysis, outcomes were compared for patients with and without rheumatic IMIDs, who were admitted for MI. A total of 1,654,862 patients were included in the study cohort; 3.6 percent had rheumatic IMIDs.

The researchers found that patients with rheumatic IMIDs were more likely to be younger, to be women, and to present with non-ST-segment-elevation MI. They were also less likely to undergo coronary angiography, percutaneous coronary intervention, or coronary artery bypass grafting. After propensity-score matching, the risks for mortality, heart failure, recurrent MI, and coronary reintervention at a median follow-up of 24 months were all higher in patients with versus without rheumatic IMIDs (adjusted hazard ratios, 1.15, 1.12, 1.08, and 1.06, respectively).

“Coronary intervention, aggressive risk factor optimization, and medical therapy intensification should be offered to these patients whenever clinically feasible to mitigate this elevated risk,” the authors write.

One author disclosed financial ties to Medtronic and Bristol Myers Squibb.

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