Background/Purpose: Rheumatoid arthritis (RA) has been associated with increased cardiovascular mortality. More intensive treatment with a focus on “treat to target” strategies are being developed, resulting in improved control of inflammation and lower levels of disability. Our literature review suggested that most of the studies were done to assess incident acute myocardial infarction (AMI) before 2010.

Our goal with this study was to evaluate recent (2010-2014) temporal trends of prevalence and mortality in AMI hospitalizations, with underlying RA in a nationally representative sample.

Methods: We reviewed the National Inpatient Sample (NIS) data over five years from 2010-2014 and identified adult AMI hospitalizations using validated ICD9-CM codes. These hospitalizations were stratified based on the secondary diagnosis of RA. Descriptive statistics were represented as means/medians for continuous and as frequencies and percentages for categorical variables. Using survey data-analysis, we calculated prevalence and in-hospital mortality.

Results: We identified 297192 hospitalizations with AMI from 2010 to 2014. Around 44557 patients had a secondary diagnosis of RA. Mean age of these patients was 70.41± 0.13 years (significantly higher than those without RA, p-value < 0.05), and 63.11% were females. There were 2315 estimated inpatient deaths from 2010-2014, with no significant difference in odds of mortality when compared to patients without RA (p value=0.75).

Conclusion: Trends in hospitalizations and inpatient mortality in RA patients hospitalized for AMI seems to have plateaued in recent years. RA patients were older and mostly females, as noted in previous studies as well. These findings are likely related to early disease recognition, improved disease control, as well as the implementation of cardiovascular risk factor modifications for patients with underlying RA. Further trends in mortality from other cardiovascular causes, such as stroke and congestive heart failure, will provide insight into other cardiovascular events.

AMI RA Table 1

AMI RA Table2

« Back to ACR/ARP Annual Meeting 2019

ACR Meeting Abstracts - https://acrabstracts.org/abstract/national-trends-in-hospitalizations-and-mortality-for-acute-myocardial-infarction-in-patients-with-rheumatoid-arthritis-data-from-national-inpatient-sample-2010-2014/