Systemic Lupus Erythematosus was associated with a higher risk of all-cause mortality up to 5 years post-AMI compared to patients without SLE (adjusted HR 1.68; 95% CI 1.48-1.92; P<0.001).
Cohort (n=784,091)
Yes
Does a diagnosis of systemic lupus erythematosus increase the risk of premature mortality after acute myocardial infarction?
Patients with SLE have a significantly higher risk of both all-cause and cardiovascular mortality up to 5 years following an acute myocardial infarction, emphasizing the need for strict secondary prevention.
Effect estimate: Adjusted HR 1.68 (95% CI 1.48-1.92)
p-value: p=<0.001
Abstract Background Acute myocardial infarction (AMI) is the leading cause of mortality within individuals with Systemic Lupus Erythematosus (SLE). SLE increases the risk of AMI but how SLE affects the long-term outcomes post AMI in a contemporary cohort of patients is poorly understood. Aims In this study we aimed to assess whether individuals with SLE have a higher premature mortality risk after AMI compared to individuals without SLE. Methods We analysed adults hospitalised between January 2005 and March 2019, with AMI from the Myocardial Ischaemia National Audit Project registry, linked with Office for National Statistics mortality reporting. We assessed long term all cause and cardiovascular mortality up to 5 years of follow up. Results Of the 784,091 patients with AMI, 715 had a current diagnosis of SLE (0.1%). Individuals with SLE were younger (median 63.9 vs 70.3 years, P0.001) and more likely to be female (76% vs 34%, P0.001). Individuals with SLE had a higher adjusted all-cause mortality at 30-day (1.36, 95% CI; 1.02,1.81, P=0.037) to 5 year follow up (1.68, 95% CI; 1.48, 1.92, P0.001). Individuals with SLE also had a higher adjusted cardiovascular mortality at 30-day (1.44, 95% CI; 1.04-1.99, P=0.028) to 5 year follow up (1.62, 95% CI; 1.34-1.96, P0.001). Conclusion There is a higher risk of premature mortality after AMI within individuals with SLE compared with those without. This further establishes individuals with SLE as higher risk cardiovascular patients and highlights the need for strict adherence to guideline directed secondary prevention.
Cole et al. (Sun,) conducted a cohort in Acute myocardial infarction (n=784,091). Systemic Lupus Erythematosus (SLE) vs. No SLE was evaluated on All-cause mortality at 5-year follow-up (Adjusted HR 1.68, 95% CI 1.48-1.92, p=<0.001). Systemic Lupus Erythematosus was associated with a higher risk of all-cause mortality up to 5 years post-AMI compared to patients without SLE (adjusted HR 1.68; 95% CI 1.48-1.92; P<0.001).