MI outcomes poorer in Medicare beneficiaries with versus without rheumatic immune-mediated inflammatory disease<\/p>\n<\/h3>\n
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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<\/em>.<\/p>\n 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.<\/p>\n 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).<\/p>\n “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.<\/p>\n One author disclosed financial ties to Medtronic and Bristol Myers Squibb.<\/p>\n