Poor outcomes after acute myocardial infarction in systemic lupus erythematosus.
OBJECTIVE
Systemic lupus erythematosus (SLE) is associated with higher risk for acute myocardial infarction (MI); but the post-infarction outcomes among these patients are unknown. Our objective was to compare post-acute MI outcomes in patients with SLE to those with diabetes mellitus (DM) and those with neither condition.


METHODS
We analyzed the risk for prolonged hospitalization and in-hospital mortality following acute MI in the 1993-2002 US Nationwide Inpatient Sample. We used logistic regression to calculate odds ratios (OR) for prolonged hospitalization and Cox proportional hazards regression to calculate hazard ratios (HR) for in-hospital mortality with and without adjustments for age, sex, race/ethnicity, socioeconomic status, and presence of congestive heart failure.


RESULTS
For the SLE (n = 2192), DM (n = 236,016), SLE/DM (n = 474), and control (n = 667,956) groups, the in-hospital mortality rates were 8.3%, 6.2%, 5.7%, and 4.7%, respectively. In multivariable regression models, all 3 disease groups had higher adverse outcome risk compared to control. The OR for prolonged hospitalization was higher for those with SLE (OR 1.48, 95% CI 1.32-1.79) compared to those with DM (OR 1.30, 95% CI 1.28-1.32). A similar pattern was observed for hazard ratios for in-hospital mortality as well (SLE, HR 1.65, 95% CI 1.33-2.04; DM, HR 1.11, 95% CI 1.07-1.14).


CONCLUSIONS
SLE, like DM, increases risk of poor outcomes after acute MI. These patients need to be triaged appropriately for aggressive care.
Shah
Mansi A
MA
Department of Internal Medicine, University of Kentucky, Lexington, Kentucky, USA.
Shah
Amber M
AM
Krishnan
Eswar
E
D000328:Adult; D001741:Black or African American; D000368:Aged; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D006630:Hispanic or Latino; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000208:ethnology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000208:ethnology / Q000401:mortality; D016017:Odds Ratio; D016016:Proportional Hazards Models; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D044465:White People