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Documented Rheumatic Disease and Post-Discharge Mortality After Acute Coronary Syndrome: A Two-Center Registry Study
Ivana Jurin1, Stela Hrkač2, Goran Šukara2
1Department of Cardiovascular Diseases, University Hospital Dubrava, 10000 Zagreb, Croatia.
Medicina (Kaunas, Lithuania)
|July 28, 2026
Summary
Patients with rheumatic disease after acute coronary syndrome (ACS) had higher rates of psychiatric disorders and worse long-term survival. Further research is needed to confirm these findings in ACS patients with rheumatic disease.
Area of Science:
- Cardiology
- Rheumatology
- Psychiatry
Background:
- Rheumatic diseases increase cardiovascular risk.
- Prognosis after acute coronary syndrome (ACS) in patients with rheumatic disease and psychiatric comorbidity is not well understood.
- Contemporary angiography-treated care outcomes for this population require further characterization.
Purpose of the Study:
- To investigate the association between documented rheumatic disease and psychiatric comorbidity.
- To evaluate the impact of rheumatic disease on post-discharge mortality after ACS.
- To assess the role of psychiatric multimorbidity in this context.
Main Methods:
- Retrospective analysis of 2950 patients undergoing coronary angiography for ACS.
- Identification of documented rheumatic disease from existing medical records.
- Primary outcome: post-discharge all-cause mortality.
Main Results:
- Rheumatic disease was present in 3.6% of patients.
- Patients with rheumatic disease were older, more often female, hypertensive, and had higher rates of psychiatric disorders (25.5% vs. 14.1%).
- Post-discharge survival was worse in patients with rheumatic disease (log-rank p = 0.013), with an adjusted hazard ratio of 1.56 (95% CI 1.04-2.34) in a parsimonious model. Psychiatric disorder independently predicted mortality.
Conclusions:
- Documented rheumatic disease in ACS patients is linked to increased psychiatric comorbidity and poorer post-discharge survival.
- These findings, from a small, documentation-defined subgroup, are hypothesis-generating due to signal attenuation in broader models and documentation-based ascertainment.
- Further investigation is warranted to establish causality and specific disease associations.
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