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Updated: Jan 19, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Disparities in management and outcomes of myocardial infarction in multiple sclerosis: A matched cohort study
Ruth Ann Marrie1, Helen Tremlett2, Elaine Kingwell2
1Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada/Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Insights
Patients with multiple sclerosis (MS) receive less cardiac care after acute myocardial infarction (AMI) and have higher mortality. This study highlights disparities in AMI management for individuals with MS.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Multiple sclerosis (MS) is associated with an increased risk of acute myocardial infarction (AMI).
- Limited understanding exists regarding the impact of MS on AMI management strategies and outcomes.
- Investigating care disparities is crucial for improving cardiovascular health in MS patients.
Purpose of the Study:
- To compare the management and outcomes of acute myocardial infarction (AMI) in patients with and without multiple sclerosis (MS).
- To assess differences in diagnostic procedures, therapeutic interventions, and mortality rates post-AMI between MS patients and matched controls.
Main Methods:
- Retrospective matched cohort study using population-based administrative health data from two Canadian provinces.
- Identified 559 MS cases and 2523 matched controls without MS.
- Compared rates of cardiac catheterization, revascularization, pharmacotherapy use, and mortality using multivariable regression and meta-analysis.
Main Results:
- The MS cohort was less likely to undergo cardiac catheterization within 30 days (OR=0.61) and revascularization (HR=0.78).
- MS patients were less likely to receive recommended post-AMI pharmacotherapy.
- Mortality risk was significantly higher at 30 and 365 days post-AMI in the MS cohort.
Conclusions:
- Individuals with MS experience lower rates of diagnostic and therapeutic care following an acute myocardial infarction compared to the general population.
- Survival rates after AMI are reduced in patients with multiple sclerosis.
- Findings underscore the need for improved cardiovascular care pathways for individuals with MS.
Background:
Although multiple sclerosis (MS) confers an elevated risk of acute myocardial infarction (AMI), little is known about how it influences management of AMI.
Methods:
Using population-based administrative (health) data from two Canadian provinces, we conducted a retrospective matched cohort study. We identified people with MS who had an incident AMI, and up to five AMI controls without MS matched on age, sex, and region. We compared the likelihood of undergoing cardiac catheterization within 30 days of AMI, time to revascularization, use of recommended pharmacotherapy post-AMI, and mortality at 30 and 365 days post-AMI using multivariable regression models adjusting for potential confounders. We pooled findings across provinces using meta-analysis.
Results:
We identified 559 MS cases and 2523 matched controls. In the matched cohort, the MS cohort was less likely to undergo cardiac catheterization within 30 days of admission (odds ratio (OR) = 0.61; 95% confidence interval (CI) = 0.49-0.77), revascularization (hazard ratio (HR) = 0.78; 95% CI = 0.69-0.88), or to fill a prescription for recommended therapy. Mortality risk was higher in the MS cohort than in the matched cohort at 30 and 365 days post-AMI.
Conclusion:
Rates of diagnostic and therapeutic care, and survival after AMI were lower in the MS population than in a matched population.
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