title: Longterm outcomes and treatment after myocardial infarction in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate the risk profiles, treatment, and outcomes of patients with rheumatoid arthritis (RA) with myocardial infarction (MI) and matched MI patients without RA.
  
  
  METHODS
  We used a population-based cohort of Olmsted County, Minnesota, residents with MI from the period 1979-2009. We identified 77 patients who fulfilled the American College of Rheumatology 1987 criteria for RA and 154 MI patients without RA matched for age, sex, and calendar year. Data collection from medical records included RA and MI characteristics, antirheumatic and cardioprotective medications, reperfusion therapy, and outcomes (mortality, heart failure, and recurrent ischemia).
  
  
  RESULTS
  The mean age at MI was 72.4 years and 55% of patients were female in both cohorts. Cardiovascular risk factor profiles, MI characteristics, and treatment with reperfusion therapy or cardioprotective medications were similar in MI patients with and those without RA. Patients with RA experienced poorer longterm outcomes compared to patients without RA--for mortality: hazard ratio (HR) 1.47; 95% CI 1.04, 2.08; and for recurrent ischemia: HR 1.51; 95% CI 1.04, 2.18.
  
  
  CONCLUSIONS
  MI patients with RA received similar treatment with reperfusion therapy and cardioprotective medications and had similar short-term outcomes compared to patients without RA. Patients with RA had poorer longterm outcomes. Despite similar treatment, MI patients with RA had worse longterm outcomes than MI patients without RA.
authors: Department of Internal Medicine, Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
authors: Sara S
authors: SS
authors: McCoy
authors: Cynthia S
authors: CS
authors: Crowson
authors: Hilal
authors: H
authors: Maradit-Kremers
authors: Terry M
authors: TM
authors: Therneau
authors: Veronique L
authors: VL
authors: Roger
authors: Eric L
authors: EL
authors: Matteson
authors: Sherine E
authors: SE
authors: Gabriel
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D002316:Cardiotonic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D015425:Myocardial Reperfusion / Q000379:methods; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012008:Recurrence; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents
keywords: MYOCARDIAL INFARCTION; RHEUMATOID ARTHRITIS; TREATMENT