Mortality after coronary artery revascularization of patients with rheumatoid arthritis

Joji J Varghese; Sushma Koneru; Steven L Scaife; Whitney E Zahnd; Mark L Francis

doi:10.1016/j.jtcvs.2009.09.036

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Mortality after coronary artery revascularization of patients with rheumatoid arthritis

Journal article

Open access

Peer reviewed

Mortality after coronary artery revascularization of patients with rheumatoid arthritis

Joji J Varghese, Sushma Koneru, Steven L Scaife, Whitney E Zahnd and Mark L Francis

The Journal of thoracic and cardiovascular surgery, Vol.140(1), pp.91-96

2010

DOI: 10.1016/j.jtcvs.2009.09.036

PMID: 19944432

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Abstract

Patients with rheumatoid arthritis have an increased risk for accelerated arthrosclerosis. It is not known, however, whether this disorder is associated with a higher risk of complications after coronary artery revascularization. We conducted a cross-sectional study of patients in the 2003–2005 Nationwide Inpatient Sample. To determine whether patients with rheumatoid arthritis had higher in-hospital mortality after coronary artery revascularization, we used logistic regression to adjust for age, sex, race/ethnicity, income, rural–urban residency, diabetes, hypertension, hyperlipidemia, Charlson comorbidities (including myocardial infarction, congestive heart failure, and diabetes), elective admission, weekend admission, and primary payer. Among patients undergoing coronary artery revascularization, those with rheumatoid arthritis were 49% less likely to die while hospitalized compared with those without rheumatoid arthritis (odds ratio, 0.51; 95% confidence interval, 0.40–0.65) after adjusting for the above confounders. In subgroup analyses that adjusted for the same confounders, patients with rheumatoid arthritis also had a 61% improvement of in-patient mortality when they underwent percutaneous coronary interventions (odds ratio, 0.39; 95% confidence interval, 0.29–0.54) along with a median of 0.32 less days hospitalized (95% confidence interval, 0.28–0.34 days). Similarly, patients with rheumatoid arthritis undergoing coronary artery bypass grafting had a 31% improvement of in-patient mortality (odds ratio, 0.69; 95% confidence interval, 0.48–0.99), with a median of 1.36 less days hospitalized (95% confidence interval, 0.72–1.12 days). Among patients undergoing coronary artery revascularization, patients with rheumatoid arthritis have an in-hospital survival advantage along with reduced days of hospitalization compared with patients without rheumatoid arthritis.

23.1

PCI

NIS

CABG

28.1

Details

Title: Subtitle: Mortality after coronary artery revascularization of patients with rheumatoid arthritis
Creators: Joji J Varghese - Department of Medicine, Southern Illinois University School of Medicine, Springfield, Ill
Sushma Koneru - Department of Medicine, Southern Illinois University School of Medicine, Springfield, Ill
Steven L Scaife - Department of Medicine, Southern Illinois University School of Medicine, Springfield, Ill
Whitney E Zahnd - Department of Medicine, Southern Illinois University School of Medicine, Springfield, Ill
Mark L Francis - Department of Medicine, Southern Illinois University School of Medicine, Springfield, Ill
Resource Type: Journal article
Publication Details: The Journal of thoracic and cardiovascular surgery, Vol.140(1), pp.91-96
Publisher: Mosby, Inc
DOI: 10.1016/j.jtcvs.2009.09.036
PMID: 19944432
ISSN: 0022-5223
eISSN: 1097-685X
Grant note: Department of Medicine at the Southern Illinois University School of Medicine
Language: English
Date published: 2010
Academic Unit: Health Management and Policy
Record Identifier: 9984214674502771

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