Short-term and long-term outcomes in rheumatoid arthritis patients following percutaneous coronary intervention: A...

Rheumatoid arthritis (RA) is associated with an elevated risk of cardiovascular disease and necessitates repeat revascularization procedures, including percutaneous coronary intervention (PCI). However, extensive data on outcomes following PCI in this cohort remain scarce. This systematic review and meta-analysis sought to evaluate the short- and long-term cardiovascular outcomes in RA patients following PCI.

We conducted a search of PubMed, Embase, Google Scholar, and Cochrane Central for studies published until October 2024 that compared RA and non-RA cohorts' post-PCI. The primary outcomes encompassed major adverse cardiovascular events, myocardial infarction, repeat revascularization, and overall mortality. The pooled odds ratio (OR) with 95% confidence intervals was computed utilizing random-effects models. A sensitivity analysis was conducted using a leave-one-out meta-analysis.

Our search identified 9 qualifying studies, encompassing nearly 1 million patients (174,229 with RA and 9771,911 without RA). Individuals with RA exhibited a markedly elevated risk of short-term stroke compared to non-RA patients (OR: 0.81, 95% CI: 0.6-1.02). Long-term follow-up found an elevated risk of myocardial infarction (OR: 1.08, 95% CI: 1.01-1.16), stroke (OR: 1.09, 95% CI: 1.07-1.11), major adverse cardiovascular events (OR: 1.12, 95% CI: 0.99-1.24), and repeat revascularization (OR: 1.09, 95% CI: 1.07-1.11) among patients with RA. The sensitivity analysis revealed no significant difference, even after the exclusion of each study.

This comprehensive meta-analysis revealed that patients with RA have markedly poorer clinical outcomes post-PCI, particularly in the long term. The results underline the necessity for tailored peri-procedural approaches and ongoing monitoring in RA patients.