Trends in mortality, co-morbidity and treatment after acute myocardial infarction in patients with rheumatoid arthritis 1998-2013

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Skielta, MattiasUmeå universitet,Reumatologi (författare)

Trends in mortality, co-morbidity and treatment after acute myocardial infarction in patients with rheumatoid arthritis 1998-2013

Artikel/kapitelEngelska2020

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2020-12-01
Sage Publications,2020
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LIBRIS-ID:oai:DiVA.org:umu-168126
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-168126URI
https://doi.org/10.1177/2048872619896069DOI

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Språk:engelska
Sammanfattning på:engelska

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Aims: Rheumatoid arthritis may influence the outcome after an acute myocardial infarction. We aimed to compare trends in one-year mortality, co-morbidities and treatments after a first acute myocardial infarction in patients with rheumatoid arthritis versus non-rheumatoid arthritis patients during 1998-2013. Furthermore, we wanted to identify characteristics associated with mortality.Methods and results: Data for 245,377 patients with a first acute myocardial infarction were drawn from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions for 1998-2013. In total, 4268 patients were diagnosed with rheumatoid arthritis. Kaplan-Meier analysis was used to study mortality trends over time and multivariable Cox regression analysis was used to identify variables associated with mortality. The one-year mortality in rheumatoid arthritis patients was initially lower compared to non-rheumatoid arthritis patients (14.7% versus 19.7%) but thereafter increased above that in non-rheumatoid arthritis patients (17.1% versus 13.5%). In rheumatoid arthritis patients the mean age at admission and the prevalence of atrial fibrillation increased over time. Congestive heart failure decreased more in non-rheumatoid arthritis than in rheumatoid arthritis patients. Congestive heart failure, atrial fibrillation, kidney failure, rheumatoid arthritis, prior diabetes mellitus and hypertension were associated with significantly higher one-year mortality during the study period 1998-2013.Conclusions: The decrease in one-year mortality after acute myocardial infarction in non-rheumatoid arthritis patients was not applicable to rheumatoid arthritis patients. This could partly be explained by an increased age at acute myocardial infarction onset and unfavourable trends with increased atrial fibrillation and congestive heart failure in rheumatoid arthritis. Rheumatoid arthritis per se was associated with a significantly worse prognosis.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Mortality
rheumatoid arthritis
myocardial infarction
congestive heart failure
atrial fibrillation

Biuppslag (personer, institutioner, konferenser, titlar ...)

Soderstrom, Lars (författare)
Rantapää-Dahlqvist, SolbrittUmeå universitet,Reumatologi(Swepub:umu)sora0001 (författare)
Jonsson, Solveig W.,1953-Umeå universitet,Reumatologi(Swepub:umu)sowa0001 (författare)
Mooe, ThomasUmeå universitet,Avdelningen för medicin(Swepub:umu)thmo0009 (författare)
Umeå universitetReumatologi (creator_code:org_t)

Sammanhörande titlar

Ingår i:European Heart Journal: Sage Publications9:8, s. 931-9382048-87262048-8734

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Av författaren/redakt...: Skielta, Mattias; Soderstrom, Lars; Rantapää-Dahlqvi ...; Jonsson, Solveig ...; Mooe, Thomas

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: European Heart J ...

Av lärosätet: Umeå universitet

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