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

Parmar, Simran Singh; Mohamed, Mohamed O.; Mamas, Mamas A; Wilkie, Ross

Abstract

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

Citation

Parmar, S. S., Mohamed, M. O., Mamas, M. A., & Wilkie, R. (in press). The clinical characteristics, managements, and outcomes of acute myocardial infarction in osteoarthritis patients; a cross-sectional analysis of 6.5 million patients. Expert Review of Cardiovascular Therapy, 22(1-3), 1-9. https://doi.org/10.1080/14779072.2024.2311696

• Journal Article Type: Article
• Acceptance Date: Jan 25, 2024
• Online Publication Date: Jan 29, 2024
• Deposit Date: Feb 19, 2024
• Journal: Expert review of cardiovascular therapy
• Print ISSN: 1477-9072
• Electronic ISSN: 1744-8344
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1-3
• Pages: 1-9
• DOI: https://doi.org/10.1080/14779072.2024.2311696
• Keywords: invasive managements, epidemiology, osteoarthritis, electronic health record data, Acute myocardial infarction