After having a heart attack, people with autoimmune diseases are more likely than others to die or experience more serious heart problems, including a second heart attack, a new study finds. rice field.
The study, published in the Journal of the American Heart Association, will help fill in known gaps about the long-term cardiovascular health of people with autoimmune diseases such as rheumatoid arthritis, psoriasis and lupus, the study says. said the person.
“The evidence regarding the risk of adverse events after heart attack in people with autoimmune diseases is less robust than in people without these diseases and comes primarily from small or single-center studies.” said senior study author Amgad Mentias, PhD, in a news release. He is an Assistant Professor of Medicine at his clinic Lerner College of Medicine in Cleveland, Ohio.
The National Institutes of Health estimates that up to 8% of people in the United States have an autoimmune disease, in which the immune system attacks its own organs, tissues, and cells.
This study used 2014-2019 data for people 65 years and older from the government database of all inpatient Medicare hospital bills in the United States. autoimmune conditions.
Patients were followed for approximately 2 years after the heart attack. Their most common autoimmune condition was rheumatoid arthritis, followed by systemic lupus, psoriasis, systemic sclerosis, and myositis/dermatomyositis.
The analysis showed that people who had an autoimmune disease after a heart attack were 15% more likely to die from any cause than those who didn’t have an autoimmune disease. They were 12% more likely to be hospitalized for heart failure, 8% more likely to have another heart attack, and more likely to have his second surgery to open an artery after a heart attack. was 6% higher.
Patients with autoimmune diseases and cardiovascular disorders should be managed by rheumatologists who work with rheumatologists, Dr. Heba Wassif, the study’s lead author, said in a release. Wassif is an Assistant Professor at the Cleveland Clinic Lerner College of Medicine and Director of Cardiac Rheumatology at the Cleveland Clinic.
Autoimmune diseases are known to increase the risk of cardiovascular disease. Perhaps because people with autoimmune diseases also tend to have more traditional cardiovascular risk factors such as hypertension, type 2 diabetes, and kidney disease. Also, because of autoimmune diseases, people usually have chronic inflammation and autoimmune antibodies and commonly use steroid medications, all of which are associated with an increased risk of cardiovascular disease. .
“Traditional[cardiovascular disease]risk factors are emphasized in this population, and how these risk factors manifest is also unique,” Wasif said. Patients with active inflammatory diseases therefore have lower cholesterol levels, a phenomenon known as the lipid paradox.Physical activity, which is strongly recommended to improve cardiovascular outcomes, is limited by joint pain. “
Also, treatment for some autoimmune diseases may increase risk, she said. “Knowledge of these nuances and a team-based approach may improve outcomes.”
The study found that people with autoimmune diseases were less likely to undergo a procedure called cardiac catheterization, which examines narrowed arteries. .
Researchers lacked information about the patient’s arterial anatomy and the severity of the autoimmune disease, which could help them understand treatment decisions.
“People with autoimmune diseases were either not healthy enough to undergo these procedures, or their coronary artery anatomy was less amenable to interventions to reopen narrowed or clogged vessels. Such problems may increase the risk of procedure-related complications.
“However, if someone is a suitable candidate, these procedures should be considered as an option, if feasible,” he said. It should not prevent sexual treatment.”
