MI, systemic inflammatory disease elevate mortality risk in young adults
Patients aged 50 years or younger who had an MI and have autoimmune systemic inflammatory diseases had elevated rates of long-term all-cause mortality, according to a study published in the European Journal of Preventive Cardiology.
“This suggests that the worse long-term survival in young heart attack patients with inflammatory diseases could be related to inflammation vs. higher prevalence of other cardiovascular risk factors,” Brittany Weber, MD, a cardio-rheumatology specialist at Brigham and Women’s Hospital and Harvard Medical School, said in a press release.
The researchers analyzed 2,097 patients, of whom 2.5% had a diagnosis of systemic inflammatory disease. Among those with systemic inflammatory disease, 64% had psoriatic disease, 23% had systemic lupus erythematosus, 9% had rheumatoid arthritis and 4% had another disease.
According to the researchers, patients with systemic inflammatory disease were more likely to be women (36% vs. 19%; P = .004) and to have a diagnosis of hypertension (62% vs. 46%; P = .025) compared with those without an inflammatory disease.
During a median follow-up of 11 years, patients with systemic inflammatory disease had higher risk for all-cause mortality compared with the full cohort of patients without systemic inflammatory disease (HR = 1.95; 95% CI, 1.07-3.57; P = .03) or a matched cohort of patients without systemic inflammatory disease based on age, sex and CV risk factors (HR = 2.68; 95% CI, 1.18-6.07; P = .018), according to the researchers.
Researchers observed that patients who had inflammatory disease were less likely to be prescribed aspirin (88% vs. 95%; P = .049) or a statin (76% vs. 89%; P= .008) when they were discharged compared with patients without systemic inflammatory disease.
According to the press release, aspirin and statins are recommended after an MI, but the researchers found that patients with inflammatory conditions were less likely to be prescribed these medications at discharge than those without inflammatory diseases.
“We were surprised at this finding, one reason could be concerns about drug-drug interactions since these patients often take medications that suppress the immune system. Given that systemic inflammatory diseases are rare, numbers in this study were small, and it is important to confirm this result in other similar cohorts,” Weber said in the release.