Long-term outcomes in patients with rheumatologic disorders undergoing percutaneous coronary intervention: a BAsel Stent Kosten-Effektivitäts Trial-PROspective Validation Examination (BASKET-PROVE) sub-study.
Eur Heart J Acute Cardiovasc Care
; 6(8): 778-786, 2017 Dec.
Article
en En
| MEDLINE
| ID: mdl-27166320
ABSTRACT
AIMS:
Rheumatologic disorders are characterised by inflammation and an increased risk of coronary artery disease (CAD). However, the association between rheumatologic disorders and long-term prognosis in CAD patients undergoing percutaneous coronary intervention (PCI) is unknown. Thus, we aimed to examine the association between rheumatologic disorders and long-term prognosis in CAD patients undergoing PCI. METHODS ANDRESULTS:
A post-hoc analysis was performed in 4605 patients (age 63.3 ± 11.0 years; male 76.6%) with ST-segment elevation myocardial infarction (STEMI; n = 1396), non-STEMI ( n = 1541), and stable CAD ( n = 1668) from the all-comer stent trials, the BAsel Stent Kosten-Effektivitäts Trial-PROspective Validation Examination (BASKET-PROVE) I and II trials. We evaluated the association between rheumatologic disorders and 2-year major adverse cardiac events (MACEs; cardiac death, nonfatal myocardial infarction (MI), and target vessel revascularisation (TVR)) by Cox regression analysis. Patients with rheumatologic disorders ( n = 197) were older, more often female, had a higher prevalence of renal disease, multi-vessel coronary disease, and bifurcation lesions, and had longer total stent lengths. During the 2-year follow-up, the MACE rate was 8.6% in the total cohort. After adjustment for potential confounders, rheumatologic disorders were associated with MACEs in the total cohort (adjusted hazard ratio 1.55; 95% confidence interval (CI) 1.04-2.31) driven by the STEMI subgroup (adjusted hazard ratio 2.38; 95% CI 1.26-4.51). In all patients, rheumatologic disorders were associated with all-cause death (adjusted hazard ratio 2.05; 95% CI 1.14-3.70), cardiac death (adjusted hazard ratio 2.63; 95% CI 1.27-5.43), and non-fatal MI (adjusted hazard ratio 2.64; 95% CI 1.36-5.13), but not with TVR (adjusted hazard ratio 0.81; 95% CI 0.41-1.58).CONCLUSIONS:
The presence of rheumatologic disorders appears to be independently associated with worse outcome in CAD patients undergoing PCI. This calls for further studies and focus on this high-risk group of patients following PCI.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Artritis Reumatoide
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Stents Liberadores de Fármacos
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Intervención Coronaria Percutánea
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Infarto del Miocardio con Elevación del ST
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Heart J Acute Cardiovasc Care
Año:
2017
Tipo del documento:
Article
País de afiliación:
Japón