The clinical characteristics, managements, and outcomes of acute myocardial infarction in osteoarthritis patients; a cross-sectional analysis of 6.5 million patients.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2024-01-31 DOI:10.1080/14779072.2024.2311696
Simran Singh Parmar, Mohamed O Mohamed, Mamas A Mamas, Ross Wilkie
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Abstract

Objectives: The prevalence of osteoarthritis (OA) and cardiovascular disease are increasing and both conditions share similar risk factors. We investigated the association between OA and receipt of invasive managements and clinical outcomes in patients with acute myocardial infarction (AMI).

Methods: Using the National Inpatient Sample, adjusted binary logistic regression determined the association between OA and each outcome variable.

Results: Of 6,561,940 AMI hospitalizations, 6.3% had OA. OA patients were older and more likely to be female. OA was associated with a decreased odds of coronary angiography (adjusted odds ratio 0.91; 95% confidence interval 0.90, 0.92), PCI (0.87; 0.87, 0.88), and coronary artery bypass grafting (0.98; 0.97, 1.00). OA was associated with a decreased odds of adverse outcomes (in-hospital mortality: 0.68; 0.67, 0.69; major acute cardiovascular and cerebrovascular events: 0.71; 0.70, 0.72; all-cause bleeding: 0.76; 0.74, 0.77; and stroke/TIA: 0.84; 0.82, 0.87).

Conclusions: This study of a representative sample of the US population highlights that OA patients are less likely to be offered invasive interventions following AMI. OA was also associated with better outcomes post-AMI, possibly attributed to a misclassification bias where unwell patients with OA were less likely to receive an OA code because codes for serious illness took precedence.

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骨关节炎患者急性心肌梗死的临床特征、处理方法和预后;对 650 万患者的横断面分析。
目的:骨关节炎(OA)和心血管疾病的发病率正在上升,这两种疾病具有相似的风险因素。我们研究了急性心肌梗死(AMI)患者的骨关节炎与接受侵入性治疗和临床结果之间的关系:方法:使用全国住院患者样本,通过调整后的二元逻辑回归确定 OA 与各结果变量之间的关系:在 6,561,940 例急性心肌梗死住院患者中,6.3% 患有 OA。OA 患者年龄更大,更可能是女性。OA与冠状动脉造影(调整后的几率比0.91;95%置信区间0.90,0.92)、PCI(0.87;0.87,0.88)和冠状动脉旁路移植术(0.98;0.97,1.00)的几率降低有关。OA 与不良预后几率的降低有关(院内死亡率:0.68;0.67,0.69;主要急性心脑血管事件:0.71;0.70,0.72):0.71;0.70,0.72;全因出血:结论:这项针对美国人口代表性样本的研究表明,OA 患者在急性心肌梗死后接受侵入性干预的可能性较小。OA也与急性心肌梗死后较好的预后有关,这可能是由于分类偏差造成的,即身体不适的OA患者不太可能获得OA代码,因为重病代码优先。
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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
期刊介绍: Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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