Systemic lupus erythematosus is associated with poor outcome after acute myocardial infarction

Nutr Metab Cardiovasc Dis. 2019 Dec;29(12):1400-1407. doi: 10.1016/j.numecd.2019.08.006. Epub 2019 Aug 20.

Abstract

Background: Systemic lupus erythematosus (SLE) is associated with a higher risk of cardiovascular disease. However, it is not clear whether or not SLE is associated with poor outcomes after acute myocardial infarction (AMI).

Methods and results: Using the Taiwan National Health Insurance Database, we identified the SLE group as patients with AMI who have a concurrent discharge diagnosis of SLE. We also selected an age-, sex-, hospital level-, and admission calendar year-matched non-SLE group at a ratio of 1:3 from the total non-SLE group. One hundred fifty-one patients with SLE, 113,791 patients without SLE, and 453 matched patients without SLE were admitted with a diagnosis of AMI. Patients with SLE were significantly younger, predominantly female, and more likely to have chronic kidney disease than those without SLE. The in-hospital mortality rates were 12.6%, 9.0%, and 4.2% in the SLE, total non-SLE, and matched non-SLE groups, respectively. The in-hospital mortality was significantly higher in the SLE group than in the total non-SLE group (OR = 1.98; 95% CI = 1.2-3.26) and the matched non-SLE group (mortality OR = 2.20; 95% CI = 1.06-4.58). In addition, the SLE group was associated with a borderline significant risk of prolonged hospitalization when compared with the non-SLE group.

Conclusion: SLE is associated with a higher risk of in-hospital mortality and a borderline significantly higher risk of prolonged hospitalization after AMI.

Keywords: Acute myocardial infarction; Mortality; Prolonged hospitalization; Systemic lupus erythematosus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Databases, Factual
  • Female
  • Hospital Mortality*
  • Humans
  • Length of Stay
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / mortality*
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / mortality*
  • Myocardial Infarction / therapy*
  • Prognosis
  • Renal Insufficiency, Chronic / mortality
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Taiwan / epidemiology
  • Time Factors
  • Young Adult