HomeHealthMedicineArthritis, other diseases may boost post-heart attack risk

Arthritis, other diseases may boost post-heart attack risk

After a heart attack, people with an autoimmune disease are more likely than others to die or have further serious heart problems, including a second heart attack, new research finds.

The study, published in the Journal of the American Heart Association, helps fill a gap in what is known about the long-term cardiovascular health of people with autoimmune diseases such as rheumatoid arthritis, psoriasis and lupus, researchers say.

“The evidence on the risk of side effects after a heart attack for people with autoimmune disorders is less robust than the evidence for people without these conditions, and mainly from small or single-center studies,” said senior study author Dr. Amgad Mentias in a news release let go. He is an assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine in Ohio.

According to estimates from the National Institutes of Health, up to 8% of people in the US have an autoimmune disease, in which the immune system attacks the body’s own organs, tissues and cells.

The study used 2014-2019 data for people age 65 and older from a government database of all US hospital bills for hospitalizations. autoimmune diseases.

Patients were followed for about two years after their heart attacks. Their most common autoimmune diseases were rheumatoid arthritis, followed by systemic lupus, psoriasis, systemic sclerosis, and myositis/dermatomyositis.

The analysis found that people with autoimmune disease after a heart attack were 15% more likely to die from any cause than those who did not have autoimmune disease. They were 12% more likely to be hospitalized for heart failure and 8% more likely to have another heart attack. They were also 6% more likely to have a second procedure to open their arteries if they had one after their heart attack.

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Patients with autoimmune and cardiovascular diseases should be treated by a cardio-rheumatologist who works in tandem with a rheumatologist, said lead study author Dr. Heba Wassif in the release. Wassif is an assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine and director of cardio-rheumatology at the Cleveland Clinic.

Autoimmune diseases are known to increase the risk of cardiovascular disease, perhaps because people who have them also have more traditional cardiovascular risk factors, including high blood pressure, type 2 diabetes, and kidney disease. And because of their autoimmune disease, people tend to have chronic inflammation and autoimmune antibodies and often take steroid drugs, all of which have been linked to higher risks of cardiovascular disease.

“Traditional (cardiovascular disease) risk factors are accentuated in this population, and how these risk factors manifest is also unique,” Wassif said. “For example, cholesterol levels are affected by inflammation. Therefore, patients with active inflammatory disease have lower cholesterol levels, a phenomenon known as the lipid paradox. Physical activity, which is highly recommended to improve cardiovascular outcomes, may be limited by joint pain.”

Also, some treatments for autoimmune diseases can increase the risk, she said. “Knowing these nuances and a team-based approach can improve results.”

In the study, people with autoimmune disease were less likely to have a procedure called cardiac catheterization to examine narrowed arteries. They were also less likely to have bypass surgery or a procedure to open clogged arteries.

Researchers lacked information about the anatomy of patients’ arteries and the severity of their autoimmune diseases that may have helped them understand treatment decision-making.

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“It’s possible that the people with autoimmune disease were not healthy enough to undergo those procedures, or that their coronary anatomy was less amenable to interventions to reopen narrowed or clogged arteries,” Mentias said. Such problems can put them at higher risk for procedure-related complications.

“However, if someone is a suitable candidate, these procedures should be considered options,” he said. “The presence of an autoimmune disease per se should not preclude a person from potentially life-saving procedures.”

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