Acute Myocardial Infarction Hospitalizations Occur at Younger Age in Gout, RA vs Osteoarthritis

The following article is a part of conference coverage from the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting, being held in Atlanta, Georgia. The team at Rheumatology Advisor will be reporting on the latest news and research conducted by leading experts in rheumatology. Check back for more from the 2019 ACR/ARP Annual Meeting.

ATLANTA — Compared with patients with secondary osteoarthritis, patients with rheumatoid arthritis (RA) or gout are admitted for acute myocardial infarction (AMI) at a younger age, according to research results presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting, held November 8 to 13, 2019, in Atlanta, Georgia.

Association with myocardial infarction may be the result of a predisposition to accelerated atherosclerosis from the pro-inflammatory disease state in gout and RA.

This study was designed to describe the demographics associated with AMI admissions and any differences between the inflammatory conditions of RA and gout and the noninflammatory condition of osteoarthritis.

Data were collected from adult patients (aged >18 years) hospitalized between 2002 and 2016 with a primary diagnosis of AMI from the national inpatient sample. Patient groups were further classified based on secondary diagnoses of gout, RA, or osteoarthritis. Demographic features were described using means/medians; rates of incidence and mortality were calculated with P <.05 used as a cutoff for statistical significance.

Among 603,359 identified hospitalizations, patients with a primary AMI diagnosis and concomitant gout or RA had a significantly younger average age of admission for RA and gout (70.9 years, 95% CI, 70.0-71.1 years and 71.7 years, 95% CI, 71.5-71.9 years, respectively) compared with patients with a secondary diagnosis of osteoarthritis (75.4 years, 95% CI, 75.3-75.6 years).

Compared with other races, black patients had a disproportionately higher incidence of AMI with a secondary gout diagnosis. Patients admitted for AMI with concomitant RA or osteoarthritis were predominantely women. Average age of mortality for patients admitted for AMI was significantly lower for patients with concomitant gout (79.0 years, 95% CI, 78.4-79.6 years) or RA (77.2 years, 95% CI, 76.5-77.9 years) compared with osteoarthritis (82.4 years, 95% CI, 82.1-82.8 years).

“Continued awareness and modification of the cardiovascular risks through disease control agents is needed in [patients] with RA and gout to optimize cardiovascular outcomes,” the study investigators concluded.

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Reference

Sen R, Aurit S, Sarsam L, et al. Acute myocardial infarction in rheumatoid arthritis, gout, and osteoarthritis: A retrospective study using the national inpatient sample from 2002-2016. Presented at: 2019 ACR/ARP Annual Meeting; November 8-13, 2019; Atlanta, GA. Abstract 2133.