umu.sePublications
Change search
ReferencesLink to record
Permanent link

Direct link
Rheumatoid arthritis is associated with a more severe presentation of acute coronary syndrome and worse short-term outcome
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
Show others and affiliations
2015 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 36, no 48, 3413-3422 p.Article in journal (Refereed) PublishedText
Abstract [en]

Aims Despite a wealth of studies describing an increased incidence of acute coronary syndromes (ACSs) in rheumatoid arthritis (RA), considerably less is known about the clinical characteristics and their association with short-term outcome of such ACS. The aims of this study were therefore to investigate clinical characteristics and case-fatality rates following ACS in patients with RA. Methods and results We compared the clinical presentation of incident ACS between 2007 and 2010 and their short-term mortality in a cohort of 1135 subjects with prevalent RA and in a cohort of 3184 matched general population comparators. Rheumatoid arthritis subjects more frequently presented with sudden cardiac death, ST-segment elevation myocardial infarctions, had higher levels of troponin and higher frequencies of in-hospital complications compared with the general population comparators. Furthermore, the short-term mortality was higher among RA-associated ACS (7-day hazard ratio (HR) = 1.65 [95% CI 1.32-2.08]; 30-day HR = 1.57 [95% CI 1.30-1.89]), which were somewhat attenuated but remained statistically significantly increased following adjustment for previous comorbidities, demographics, and educational level (7-day HR = 1.50 [95% CI 1.19-1.90]; 30-day HR = 1.43 [95% CI 1.18-1.72]), and for ACS type (7-day HR = 1.44 [95% CI 1.14-1.82]; 30-day HR = 1.36 [95% CI 1.13-1.64]). Conclusion Patients with prevalent RA suffer more severe ACSs compared with the general population and also have poorer outcomes after the events, which can only partly be explained by increased event severity.

Place, publisher, year, edition, pages
Oxford University Press, 2015. Vol. 36, no 48, 3413-3422 p.
Keyword [en]
Rheumatoid arthritis, Acute coronary syndrome, Mortality, Epidemiology
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-118277DOI: 10.1093/eurheartj/ehv461ISI: 000370373900008PubMedID: 26400826OAI: oai:DiVA.org:umu-118277DiVA: diva2:912375
Available from: 2016-03-16 Created: 2016-03-14 Last updated: 2016-03-16Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Wållberg-Jonsson, Solveig
By organisation
Reumatology
In the same journal
European Heart Journal
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 12 hits
ReferencesLink to record
Permanent link

Direct link