People with autoimmune disease have a higher complication rate after heart attack: Study

After a heart attack, people with an autoimmune disease were more likely to die, develop heart failure or have a second heart attack compared to people without an autoimmune disease, according to new research published today in the Journal of the American Heart Association.

Autoimmune diseases, are known to increase risk of cardiovascular disease, likely due to multiple factors. People with an autoimmune disease have a higher prevalence of traditional cardiovascular risk factors in addition to aspects of autoimmune disease that are also linked to higher cardiovascular risk and long-term use of steroid medications.

The researchers identified 1,654,862 people in the U.S. ages 65 and older in the Medicare Provider Analysis and Review (MedPAR) File who were admitted to the hospital with a heart attack diagnosis between 2014 and 2019. Of those records, 3.6% (60,072) had an inflammation-causing autoimmune disease noted in their charts within the previous year. The most common condition was rheumatoid arthritis, followed by systemic lupus, psoriasis, systemic sclerosis and myositis/dermatomyositis. They found several important differences among people with vs. without autoimmune disease who had heart attacks:

People with an auto immune disease were slightly younger – average age was 77.1 years vs. 77.6 years for those without an autoimmune disease. More of those with an autoimmune disease were women (66.9% vs. 44.2%). Those with autoimmune disease were more likely to have had a non-ST-elevation myocardial infarction (NSTEMI) heart attack and they were less likely to have an ST-elevation myocardial infarction (STEMI) heart attack

The analysis found that people with an autoimmune disease were:

15% more likely to die from any cause;

12% more likely to be hospitalized for heart failure;

8% more likely to have another heart attack; and

6% more likely to have an additional artery-opening procedure (if they had received one at the time of their heart attack).

The researchers also found that people with an autoimmune disease were less likely to have heart catheterization to assess narrowed coronary arteries or to undergo an artery-opening procedure or bypass surgery regardless of the type of heart attack.

Ref:

Amgad Mentias et al,Journal of the American Heart Association DOI10.1161/JAHA.122.026411