title: Increased risk of acute myocardial infarction and mortality in patients with systemic lupus erythematosus: two nationwide retrospective cohort studies.
abstract: BACKGROUND
  This study evaluated the risk of acute myocardial infarction (AMI) and mortality among patients with systemic lupus erythematosus (SLE) in two nationwide retrospective cohort studies.
  
  
  METHODS
  Using Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study and identified 1207 adults newly diagnosed with SLE in 2000-2004. Non-SLE cohort consisted of 9656 adults without SLE, frequency-matched for age and sex and randomly selected from the same data set. Events of AMI were considered as outcome during the follow-up period between 2000 and 2008. Another nested cohort study of 6900 patients with AMI receiving cardiac surgeries was conducted to analyze the impact of SLE on post-AMI mortality.
  
  
  RESULTS
  During the follow-up period, there were 52 newly diagnosed AMI cases. The incidences of AMI for SLE cohort and non-SLE cohort were 2.10 and 0.49 per 1000 person-years, respectively, with an adjusted hazard ratio (HR) of 5.11 (95% confidence interval [CI] 2.63-9.92). For females, the adjusted HR of AMI associated with SLE was as high as 6.28 (95% CI 2.67-14.7). Further analyses in the nested cohort showed that SLE was significantly associated with post-AMI mortality (odds ratio, 2.60; 95% CI 1.09-6.19).
  
  
  CONCLUSIONS
  Patients with SLE had higher risk of AMI compared with non-SLE control, and this risk was more significant in females. In addition, SLE is an independent risk factor for post-AMI mortality.
authors.affiliation: Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chiao-Yi
authors.initials: CY
authors.lastname: Lin
authors.affiliation: School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Chun-Chuan
authors.initials: CC
authors.lastname: Shih
authors.affiliation: Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Department of Surgery, University of Illinois, Chicago, USA.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yeh
authors.affiliation: Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Wan-Hsin
authors.initials: WH
authors.lastname: Chou
authors.affiliation: Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ta-Liang
authors.initials: TL
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: jacky48863027@yahoo.com.tw.
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Mortality; Myocardial infarction; Systemic lupus erythematosus