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Long-term outcomes in patients with rheumatologic disorders undergoing percutaneous coronary intervention: a BAsel

Kotaro Nochioka1, Tor Biering-Sørensen2, Kim Wadt Hansen3

  • 11 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan.

European Heart Journal. Acute Cardiovascular Care
|May 12, 2016
PubMed

Insights

Patients with rheumatologic disorders undergoing percutaneous coronary intervention (PCI) face a higher risk of major adverse cardiac events (MACEs), including cardiac death and myocardial infarction. This highlights the need for focused care in this high-risk population post-PCI.

Area of Science:

  • Cardiology
  • Rheumatology
  • Interventional Cardiology

Background:

  • Rheumatologic disorders are linked to increased coronary artery disease (CAD) risk due to inflammation.
  • The long-term prognosis of CAD patients with rheumatologic disorders after percutaneous coronary intervention (PCI) remains unclear.

Purpose of the Study:

  • To investigate the association between rheumatologic disorders and the long-term prognosis of patients with CAD undergoing PCI.

Main Methods:

  • A post-hoc analysis of 4605 patients from the BASKET-PROVE I and II trials was conducted.
  • Patients with ST-segment elevation myocardial infarction (STEMI), non-STEMI, and stable CAD were evaluated.
  • Cox regression analysis assessed the association between rheumatologic disorders and 2-year major adverse cardiac events (MACEs), including cardiac death, nonfatal myocardial infarction (MI), and target vessel revascularisation (TVR).

Main Results:

  • Patients with rheumatologic disorders (n=197) were older, more often female, and had higher rates of renal disease and multi-vessel CAD.
  • The overall 2-year MACE rate was 8.6%.
  • Rheumatologic disorders were independently associated with MACEs (adjusted hazard ratio [aHR]: 1.55), driven by the STEMI subgroup (aHR: 2.38). These disorders also correlated with all-cause death (aHR: 2.05), cardiac death (aHR: 2.63), and non-fatal MI (aHR: 2.64), but not TVR (aHR: 0.81).

Conclusions:

  • Rheumatologic disorders are independently associated with worse long-term outcomes in CAD patients following PCI.
  • This finding underscores the importance of identifying and managing this high-risk patient group.
  • Further research is warranted to optimize care for rheumatologic patients undergoing PCI.
Abstract

Keywords:
Coronary artery diseaseprognosisrevascularisationrheumatologic disorders

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