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Outcomes of Percutaneous Coronary Intervention in Elderly Patients with Rheumatoid Arthritis: A Nationwide

Bo Young Kim1, HyeSung Moon2, Sung-Soo Kim1

  • 1Division of Rheumatology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea.

Healthcare (Basel, Switzerland)
|May 27, 2023
PubMed

Insights

Elderly patients with rheumatoid arthritis (RA) undergoing percutaneous coronary intervention (PCI) face higher mortality risks. Young-onset RA patients showed better survival than elderly-onset RA patients after PCI.

Area of Science:

  • Cardiology
  • Rheumatology
  • Geriatrics

Background:

  • Rheumatoid arthritis (RA) is a significant risk factor for cardiovascular disease.
  • Understanding the impact of RA on outcomes after percutaneous coronary intervention (PCI) in elderly populations is crucial.

Purpose of the Study:

  • To evaluate and compare the clinical outcomes, specifically survival rates, of elderly patients with and without rheumatoid arthritis (RA) following percutaneous coronary intervention (PCI).

Main Methods:

  • A retrospective analysis of 74,623 elderly patients (≥ 65 years) who underwent PCI for acute coronary syndrome between 2008-2019 using the Korean National Health Insurance Service claims database.
  • Comparison of all-cause mortality between patients with RA (n=14,074) and without RA (n=60,549).
  • Subgroup analysis of survival outcomes based on the onset age of RA (young-onset vs. elderly-onset).

Main Results:

  • Elderly patients with RA had a significantly lower survival rate compared to those without RA over a 10-year follow-up (53.7% vs. 58.3%, p < 0.001).
  • Within the RA subgroup, patients with young-onset RA demonstrated better survival outcomes than those with elderly-onset RA and patients without RA (73.7% vs. 48.1% vs. 58.3%, p < 0.001).
  • Elderly RA patients undergoing PCI experienced an elevated mortality risk, particularly those with elderly-onset RA.

Conclusions:

  • Elderly patients with rheumatoid arthritis undergoing PCI have an increased risk of mortality.
  • The age of RA onset significantly influences survival outcomes in elderly patients post-PCI, with young-onset RA associated with better prognosis than elderly-onset RA.

Keywords:
elderly patientsmortalitypercutaneous coronary interventionrheumatoid arthritis

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