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Systemic lupus erythematosus is associated with poor outcome after acute myocardial infarction
Shin-Rong Ke1, Cheng-Wei Liu2, Yen-Wen Wu3
1Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Insights
Patients with systemic lupus erythematosus (SLE) face increased in-hospital mortality and prolonged hospitalization after acute myocardial infarction (AMI). This study highlights poorer outcomes for SLE patients experiencing heart attacks.
Area of Science:
- Cardiology
- Rheumatology
- Public Health
Background:
- Systemic lupus erythematosus (SLE) is linked to elevated cardiovascular disease risk.
- The impact of SLE on acute myocardial infarction (AMI) outcomes remains unclear.
Purpose of the Study:
- To investigate the association between SLE and patient outcomes following AMI.
- To compare in-hospital mortality and hospitalization duration in AMI patients with and without SLE.
Main Methods:
- Utilized the Taiwan National Health Insurance Database for patient identification.
- Matched 151 SLE patients with AMI against 453 non-SLE AMI patients based on demographics and admission year.
- Analyzed in-hospital mortality and hospitalization length.
Main Results:
- SLE patients were younger, predominantly female, and had higher rates of chronic kidney disease.
- In-hospital mortality was significantly higher in the SLE group (12.6%) compared to matched non-SLE controls (4.2%).
- A borderline significant increase in prolonged hospitalization was observed for SLE patients.
Conclusions:
- Systemic lupus erythematosus (SLE) is associated with increased in-hospital mortality post-AMI.
- SLE patients exhibit a borderline significantly higher risk of prolonged hospitalization after acute myocardial infarction.
Background:
Systemic lupus erythematosus (SLE) is associated with a higher risk of cardiovascular disease. However, it is not clear whether or not SLE is associated with poor outcomes after acute myocardial infarction (AMI).
Methods And Results:
Using the Taiwan National Health Insurance Database, we identified the SLE group as patients with AMI who have a concurrent discharge diagnosis of SLE. We also selected an age-, sex-, hospital level-, and admission calendar year-matched non-SLE group at a ratio of 1:3 from the total non-SLE group. One hundred fifty-one patients with SLE, 113,791 patients without SLE, and 453 matched patients without SLE were admitted with a diagnosis of AMI. Patients with SLE were significantly younger, predominantly female, and more likely to have chronic kidney disease than those without SLE. The in-hospital mortality rates were 12.6%, 9.0%, and 4.2% in the SLE, total non-SLE, and matched non-SLE groups, respectively. The in-hospital mortality was significantly higher in the SLE group than in the total non-SLE group (OR = 1.98; 95% CI = 1.2-3.26) and the matched non-SLE group (mortality OR = 2.20; 95% CI = 1.06-4.58). In addition, the SLE group was associated with a borderline significant risk of prolonged hospitalization when compared with the non-SLE group.
Conclusion:
SLE is associated with a higher risk of in-hospital mortality and a borderline significantly higher risk of prolonged hospitalization after AMI.
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