Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis
Rheumatoid arthritis (RA) is the most common inflammatory arthritis and is associated with increased risk of cardiovascular events and mortality. Evidence regarding outcomes following PCI is limited. This study aimed to assess differences in outcomes following percutaneous coronary intervention (PCI...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
2021
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1111170 http://hdl.handle.net/20.500.11937/93760 |
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| author | Dawson, L.P. Dinh, D. O'Brien, J. Duffy, S.J. Guymer, E. Brennan, A. Clark, D. Oqueli, E. Hiew, C. Freeman, M. Reid, Christopher Ajani, A.E. |
| author_facet | Dawson, L.P. Dinh, D. O'Brien, J. Duffy, S.J. Guymer, E. Brennan, A. Clark, D. Oqueli, E. Hiew, C. Freeman, M. Reid, Christopher Ajani, A.E. |
| author_sort | Dawson, L.P. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Rheumatoid arthritis (RA) is the most common inflammatory arthritis and is associated with increased risk of cardiovascular events and mortality. Evidence regarding outcomes following PCI is limited. This study aimed to assess differences in outcomes following percutaneous coronary intervention (PCI) between patients with and without RA. The Melbourne Interventional Group PCI registry (2005 to 2018) was used to identify 756 patients with RA. Outcomes were compared with the remaining cohort (n = 38,579). Patients with RA were older, more often female, with higher rates of hypertension, previous stroke, peripheral vascular disease, obstructive sleep apnea, chronic lung disease, myocardial infarction, and renal impairment, whereas rates of dyslipidemia and current smoking were lower, all p <0.05. Lesions in patients with RA were more frequently complex (ACC/AHA type B2/C), requiring longer stents, with higher rates of no reflow, all p <0.05. Risk of long-term mortality, adjusted for potential confounders, was higher for patients with RA (hazard ratio 1.53, 95% confidence interval 1.30 to 1.80; median follow-up 5.0 years), whereas 30-day outcomes including mortality, major adverse cardiovascular events, bleeding, stroke, myocardial infarction, coronary artery bypass surgery, and target vessel revascularization were similar. In subgroup analysis, patients with RA and lower BMI (Pfor interaction < 0.001) and/or acute coronary syndromes (Pfor interaction = 0.05) had disproportionately higher risk of long-term mortality compared with patients without RA. In conclusion, patients with RA who underwent PCI had more co-morbidities and longer, complex coronary lesions. Risk of short-term adverse outcomes was similar, whereas risk of long-term mortality was higher, especially among patients with acute coronary syndromes and lower body mass index. |
| first_indexed | 2025-11-14T11:40:43Z |
| format | Journal Article |
| id | curtin-20.500.11937-93760 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:40:43Z |
| publishDate | 2021 |
| publisher | EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-937602024-01-09T07:18:06Z Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis Dawson, L.P. Dinh, D. O'Brien, J. Duffy, S.J. Guymer, E. Brennan, A. Clark, D. Oqueli, E. Hiew, C. Freeman, M. Reid, Christopher Ajani, A.E. Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology ACUTE MYOCARDIAL-INFARCTION SYSTEMIC-LUPUS-ERYTHEMATOSUS LONG-TERM OUTCOMES ARTERY-DISEASE RISK ASSOCIATION DIAGNOSIS PLAQUE Aged Aged, 80 and over Arthritis, Rheumatoid Coronary Artery Disease Female Follow-Up Studies Humans Male Middle Aged Percutaneous Coronary Intervention Propensity Score Prospective Studies Registries Risk Factors Survival Rate Time Factors Treatment Outcome Victoria Melbourne Interventional Group (MIG) Investigators Humans Arthritis, Rheumatoid Treatment Outcome Registries Survival Rate Risk Factors Follow-Up Studies Prospective Studies Time Factors Aged Aged, 80 and over Middle Aged Victoria Female Male Coronary Artery Disease Propensity Score Percutaneous Coronary Intervention Rheumatoid arthritis (RA) is the most common inflammatory arthritis and is associated with increased risk of cardiovascular events and mortality. Evidence regarding outcomes following PCI is limited. This study aimed to assess differences in outcomes following percutaneous coronary intervention (PCI) between patients with and without RA. The Melbourne Interventional Group PCI registry (2005 to 2018) was used to identify 756 patients with RA. Outcomes were compared with the remaining cohort (n = 38,579). Patients with RA were older, more often female, with higher rates of hypertension, previous stroke, peripheral vascular disease, obstructive sleep apnea, chronic lung disease, myocardial infarction, and renal impairment, whereas rates of dyslipidemia and current smoking were lower, all p <0.05. Lesions in patients with RA were more frequently complex (ACC/AHA type B2/C), requiring longer stents, with higher rates of no reflow, all p <0.05. Risk of long-term mortality, adjusted for potential confounders, was higher for patients with RA (hazard ratio 1.53, 95% confidence interval 1.30 to 1.80; median follow-up 5.0 years), whereas 30-day outcomes including mortality, major adverse cardiovascular events, bleeding, stroke, myocardial infarction, coronary artery bypass surgery, and target vessel revascularization were similar. In subgroup analysis, patients with RA and lower BMI (Pfor interaction < 0.001) and/or acute coronary syndromes (Pfor interaction = 0.05) had disproportionately higher risk of long-term mortality compared with patients without RA. In conclusion, patients with RA who underwent PCI had more co-morbidities and longer, complex coronary lesions. Risk of short-term adverse outcomes was similar, whereas risk of long-term mortality was higher, especially among patients with acute coronary syndromes and lower body mass index. 2021 Journal Article http://hdl.handle.net/20.500.11937/93760 10.1016/j.amjcard.2020.10.048 English http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1136372 EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC restricted |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology ACUTE MYOCARDIAL-INFARCTION SYSTEMIC-LUPUS-ERYTHEMATOSUS LONG-TERM OUTCOMES ARTERY-DISEASE RISK ASSOCIATION DIAGNOSIS PLAQUE Aged Aged, 80 and over Arthritis, Rheumatoid Coronary Artery Disease Female Follow-Up Studies Humans Male Middle Aged Percutaneous Coronary Intervention Propensity Score Prospective Studies Registries Risk Factors Survival Rate Time Factors Treatment Outcome Victoria Melbourne Interventional Group (MIG) Investigators Humans Arthritis, Rheumatoid Treatment Outcome Registries Survival Rate Risk Factors Follow-Up Studies Prospective Studies Time Factors Aged Aged, 80 and over Middle Aged Victoria Female Male Coronary Artery Disease Propensity Score Percutaneous Coronary Intervention Dawson, L.P. Dinh, D. O'Brien, J. Duffy, S.J. Guymer, E. Brennan, A. Clark, D. Oqueli, E. Hiew, C. Freeman, M. Reid, Christopher Ajani, A.E. Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis |
| title | Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis |
| title_full | Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis |
| title_fullStr | Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis |
| title_full_unstemmed | Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis |
| title_short | Outcomes of Percutaneous Coronary Intervention in Patients With Rheumatoid Arthritis |
| title_sort | outcomes of percutaneous coronary intervention in patients with rheumatoid arthritis |
| topic | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology ACUTE MYOCARDIAL-INFARCTION SYSTEMIC-LUPUS-ERYTHEMATOSUS LONG-TERM OUTCOMES ARTERY-DISEASE RISK ASSOCIATION DIAGNOSIS PLAQUE Aged Aged, 80 and over Arthritis, Rheumatoid Coronary Artery Disease Female Follow-Up Studies Humans Male Middle Aged Percutaneous Coronary Intervention Propensity Score Prospective Studies Registries Risk Factors Survival Rate Time Factors Treatment Outcome Victoria Melbourne Interventional Group (MIG) Investigators Humans Arthritis, Rheumatoid Treatment Outcome Registries Survival Rate Risk Factors Follow-Up Studies Prospective Studies Time Factors Aged Aged, 80 and over Middle Aged Victoria Female Male Coronary Artery Disease Propensity Score Percutaneous Coronary Intervention |
| url | http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1111170 http://hdl.handle.net/20.500.11937/93760 |