| Institution: | 1. Department of Cardiology, Dupuytren-2 University Hospital, 87042 Limoges, France;2. EpiMaCT, Inserm 1094 & IRD 270, Limoges University, 87000 Limoges, France;1. Department of Cardiology, Saint Antoine and Tenon Hospitals, AP–HP, Sorbonne Université, Paris, France;2. INSERM UMRS 1166, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Paris, France;3. Department of Cardiology, centre hospitalier universitaire Dijon Bourgogne, 21079 Dijon, France;4. Service de neurologie, hôpital Bichat-Claude-Bernard, AP–HP, 75018 Paris, France;1. Department of Cardiology, Amiens University Hospital, 80054 Amiens, France;2. EA 7517 MP3CV, Jules-Verne University of Picardie, 80054 Amiens, France;1. Department of Cardiology, Rangueil University Hospital, Toulouse University School of Medicine, TSA 50032, 31059 Toulouse, France;2. Department of Cardiology, Rangueil University Hospital, Toulouse University School of Medicine, 31400 Toulouse, France;3. INSERM UMR 1295, Toulouse Paul Sabatier University, 31000 Toulouse, France;1. Department of cardiology, Amiens university hospital, avenue René-Laennec, 80054 cedex 1 Amiens, France;2. Department of radiology, Tours university hospital, 37000 Tours, France;3. UR UPJV 7517, Jules-Verne university of Picardie, 80054 Amiens, France;4. Department of cardiology, centre cardio-thoracique de Monaco, 98000 Monaco;5. Department of cardiology, Tours university hospital, 37000 Tours; and EA4245, university of Tours, 37032 Tours, France;6. Department of radiology, Amiens university hospital, 80054 Amiens, France;7. Department of thoracic surgery, Tours university hospital, 37000 Tours, France;1. Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, LRB, 38000 Grenoble, France;2. Department of Cardiology, CHU Grenoble Alpes, 38000 Grenoble, France;3. French Alliance Clinical Trial, French Clinical Research Infrastructure Network, 75018 Paris, France;1. Cardiology Unit, San Giovanni di Dio Hospital, Florence 50142, Italy;2. Department of Medical Biotechnologies, Section of Cardiology, University of Siena, 53100 Siena, Italy |
| Abstract: | BackgroundPatients with chronic inflammatory diseases (CIDs) are at increased risk of cardiovascular events. However, the prognostic impact of CID after an acute coronary event has been poorly studied.AimsTo examine the effect of history of CID on long-term outcome in patients with ST-segment elevation myocardial infarction (STEMI).MethodsWe analysed data from SCALIM, a regional registry that prospectively enrolled patients with STEMI between June 2011 and May 2019. The presence of CID (including inflammatory bowel diseases, rheumatic conditions, inflammatory skin diseases, multiple sclerosis, vasculitis and autoimmune diseases) was identified. The primary outcome was all-cause death. Secondary outcomes were cardiovascular death, myocardial infarction, ischaemic stroke, peripheral vascular events and rehospitalization for cardiovascular conditions.ResultsData from 1941 patients with STEMI (mean age 64.8 ± 14.1 years, 75.1% men) were analyzed. The prevalence of any CID was 4.6% (n = 89). After a mean follow-up of 3.4 ± 2.6 years, the overall death rate was 16.2%, with similar 5-year survival between patients with and without CID (74.2% vs. 81.9%, respectively; P = 0.121), with no significant mortality excess (hazard ratio: 1.15, 95% confidence interval: 0.73 ? 1.82; P = 0.55). However, among CID patients, 35 (39.3%) were on corticosteroid therapy and showed decreased 5-year survival (52.8% vs. 89.5% without corticosteroids; P = 0.001). We found no increased rate of secondary endpoints, except for peripheral vascular events (5-year survival free of peripheral events: 93.3% vs. 98.6% in those without CID; P = 0.005).ConclusionsApproximately 1 in 20 patients with STEMI has CID. We found no effect of CID on long-term survival. However, patients on corticosteroid therapy appeared to have higher rates of death during follow-up. Whether this finding is related to the use of corticosteroids or to the more progressive nature of their condition warrants further investigation. |
