title: Long-term outcomes in patients with rheumatologic disorders undergoing percutaneous coronary intervention: a BAsel Stent Kosten-Effektivitäts Trial-PROspective Validation Examination (BASKET-PROVE) sub-study.
abstract: OBJECTIVE
  Rheumatologic disorders are characterised by inflammation and an increased risk of coronary artery disease (CAD). However, the association between rheumatologic disorders and long-term prognosis in CAD patients undergoing percutaneous coronary intervention (PCI) is unknown. Thus, we aimed to examine the association between rheumatologic disorders and long-term prognosis in CAD patients undergoing PCI.
  
  
  RESULTS
  A post-hoc analysis was performed in 4605 patients (age: 63.3 ± 11.0 years; male: 76.6%) with ST-segment elevation myocardial infarction (STEMI; n = 1396), non-STEMI ( n = 1541), and stable CAD ( n = 1668) from the all-comer stent trials, the BAsel Stent Kosten-Effektivitäts Trial-PROspective Validation Examination (BASKET-PROVE) I and II trials. We evaluated the association between rheumatologic disorders and 2-year major adverse cardiac events (MACEs; cardiac death, nonfatal myocardial infarction (MI), and target vessel revascularisation (TVR)) by Cox regression analysis. Patients with rheumatologic disorders ( n = 197) were older, more often female, had a higher prevalence of renal disease, multi-vessel coronary disease, and bifurcation lesions, and had longer total stent lengths. During the 2-year follow-up, the MACE rate was 8.6% in the total cohort. After adjustment for potential confounders, rheumatologic disorders were associated with MACEs in the total cohort (adjusted hazard ratio: 1.55; 95% confidence interval (CI): 1.04-2.31) driven by the STEMI subgroup (adjusted hazard ratio: 2.38; 95% CI: 1.26-4.51). In all patients, rheumatologic disorders were associated with all-cause death (adjusted hazard ratio: 2.05; 95% CI: 1.14-3.70), cardiac death (adjusted hazard ratio: 2.63; 95% CI: 1.27-5.43), and non-fatal MI (adjusted hazard ratio: 2.64; 95% CI: 1.36-5.13), but not with TVR (adjusted hazard ratio: 0.81; 95% CI: 0.41-1.58).
  
  
  CONCLUSIONS
  The presence of rheumatologic disorders appears to be independently associated with worse outcome in CAD patients undergoing PCI. This calls for further studies and focus on this high-risk group of patients following PCI.
authors.affiliation: 1 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Nochioka
authors.affiliation: 2 Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Tor
authors.initials: T
authors.lastname: Biering-Sørensen
authors.affiliation: 3 Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
authors.forename: Kim Wadt
authors.initials: KW
authors.lastname: Hansen
authors.affiliation: 2 Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Sørensen
authors.affiliation: 2 Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Sune
authors.initials: S
authors.lastname: Pedersen
authors.affiliation: 2 Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Peter Godsk
authors.initials: PG
authors.lastname: Jørgensen
authors.affiliation: 2 Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Iversen
authors.affiliation: 1 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
authors.affiliation: 4 Department of Cardiology, University Hospital, Basel, Switzerland.
authors.forename: Raban
authors.initials: R
authors.lastname: Jeger
authors.affiliation: 4 Department of Cardiology, University Hospital, Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kaiser
authors.affiliation: 4 Department of Cardiology, University Hospital, Basel, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Pfisterer
authors.affiliation: 3 Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Galatius
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D011474:Prosthesis Design; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Coronary artery disease; prognosis; revascularisation; rheumatologic disorders