Mortality after coronary artery revascularization of patients with rheumatoid arthritis

J Thorac Cardiovasc Surg. 2010 Jul;140(1):91-6. doi: 10.1016/j.jtcvs.2009.09.036. Epub 2009 Nov 26.


Objective: Patients with rheumatoid arthritis have an increased risk for accelerated atherosclerosis. It is not known, however, whether this disorder is associated with a higher risk of complications after coronary artery revascularization.

Methods: We conducted a cross-sectional study of patients in the 2003-2005 Nationwide Inpatient Sample. To determine whether patients with rheumatoid arthritis had higher in-hospital mortality after coronary artery revascularization, we used logistic regression to adjust for age, sex, race/ethnicity, income, rural-urban residency, diabetes, hypertension, hyperlipidemia, Charlson comorbidities (including myocardial infarction, congestive heart failure, and diabetes), elective admission, weekend admission, and primary payer.

Results: Among patients undergoing coronary artery revascularization, those with rheumatoid arthritis were 49% less likely to die while hospitalized compared with those without rheumatoid arthritis (odds ratio, 0.51; 95% confidence interval, 0.40-0.65) after adjusting for the above confounders. In subgroup analyses that adjusted for the same confounders, patients with rheumatoid arthritis also had a 61% improvement of in-patient mortality when they underwent percutaneous coronary interventions (odds ratio, 0.39; 95% confidence interval, 0.29-0.54) along with a median of 0.32 less days hospitalized (95% confidence interval, 0.28-0.34 days). Similarly, patients with rheumatoid arthritis undergoing coronary artery bypass grafting had a 31% improvement of in-patient mortality (odds ratio, 0.69; 95% confidence interval, 0.48-0.99), with a median of 1.36 less days hospitalized (95% confidence interval, 0.72-1.12 days).

Conclusion: Among patients undergoing coronary artery revascularization, patients with rheumatoid arthritis have an in-hospital survival advantage along with reduced days of hospitalization compared with patients without rheumatoid arthritis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / mortality*
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / mortality*
  • Comorbidity
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / mortality*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / mortality*
  • Coronary Artery Disease / therapy*
  • Cross-Sectional Studies
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology