Mohamed, MO ORCID: https://orcid.org/0000-0002-9678-5222, Martinez, S, Potts, J, Abhishek, A, Roddy, E ORCID: https://orcid.org/0000-0001-8699-0735, Savage, M, Bharadwaj, A, Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Bagur, R ORCID: https://orcid.org/0000-0003-1888-9429 and Mamas, M ORCID: https://orcid.org/0000-0001-9241-8890 (2020) Percutaneous Coronary Intervention Outcomes in Patients with Rheumatoid Arthritis, Systemic Lupus Erythematosus and Systemic sclerosis. Rheumatology, 59 (9). pp. 2512-2522.

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Abstract

Objective
Patients with autoimmune rheumatic disease (AIRD) are at an increased risk of coronary artery disease. The present study sought to examine the prevalence and outcomes of AIRD patients undergoing percutaneous coronary intervention (PCI) from a national perspective.

Methods
All PCI-related hospitalizations recorded in the US National Inpatient Sample (2004–2014) were included, stratified into four groups: no AIRD, RA, SLE and SSc. We examined the prevalence of AIRD subtypes and assessed their association with in-hospital adverse events using multivariable logistic regression [odds ratios (OR) (95% CI)].

Results
Patients with AIRD represented 1.4% (n = 90 469) of PCI hospitalizations. The prevalence of RA increased from 0.8% in 2004 to 1.4% in 2014, but other AIRD subtypes remained stable. In multivariable analysis, the adjusted odds ratio (aOR) of in-hospital complications [aOR any complication 1.13 (95% CI 1.01, 1.26), all-cause mortality 1.32 (1.03, 1.71), bleeding 1.50 (1.30, 1.74), stroke 1.36 (1.14, 1.62)] were significantly higher in patients with SSc compared with those without AIRD. There was no difference in complications between the SLE and RA groups and those without AIRD, except higher odds of bleeding in SLE patients [aOR 1.19 (95% CI 1.09, 1.29)] and reduced odds of all-cause mortality in RA patients [aOR 0.79 (95% CI 0.70, 0.88)].

Conclusion
In a nationwide cohort of US hospitalizations, we demonstrate increased rates of all adverse clinical outcomes following PCI in people with SSc and increased bleeding in SLE. Management of such patients should involve a multiteam approach with rheumatologists.

Item Type: Article
Additional Information: © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
Uncontrolled Keywords: Percutaneous, coronary intervention outcomes, rheumatoid arthritis, systematic lupus erythematosus, systematic sclerosis.
Subjects: Q Science > Q Science (General)
R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 29 Nov 2019 13:23
Last Modified: 22 Oct 2020 12:36
URI: https://eprints.keele.ac.uk/id/eprint/7315

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