Kim Bo Young, Moon HyeSung, Kim Sung-Soo, Kim Hyun-Sook
Division of Rheumatology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea.
Rexsoft Corp., Seoul 08826, Republic of Korea.
Healthcare (Basel). 2023 May 10;11(10):1381. doi: 10.3390/healthcare11101381.
Rheumatoid arthritis (RA) increases the risk of cardiovascular disease. This study aimed to evaluate the clinical outcomes of elderly patients with and without RA who underwent percutaneous coronary intervention (PCI). The Korean National Health Insurance Service claims database was used to extract data on 74,623 patients (14,074 with RA and 60,549 without RA) aged ≥ 65 years who were diagnosed with acute coronary syndrome and underwent PCI between 2008 and 2019. The primary outcome was survival of elderly patients with and without RA. The secondary outcome was survival in the RA subgroup. During a 10-year follow-up, the all-cause mortality survival rate was lower in patients with RA than that in patients without (53.7% vs. 58.3%, respectively, log-rank: < 0.001). In the all-cause mortality RA subgroup, patients with elderly-onset RA had poor survival outcomes, whereas patients with young-onset RA had good survival outcomes compared with that in patients without RA (48.1% vs. 73.7% vs. 58.3%, respectively, log-rank: < 0.001). Elderly patients with RA who underwent PCI had an increased mortality risk, particularly those with elderly rather than young-onset RA.
类风湿性关节炎（RA）会增加心血管疾病的风险。本研究旨在评估接受经皮冠状动脉介入治疗（PCI）的老年RA患者和非RA患者的临床结局。利用韩国国民健康保险服务索赔数据库，提取了2008年至2019年间74623例年龄≥65岁、被诊断为急性冠状动脉综合征并接受PCI治疗的患者的数据（14074例患有RA，60549例未患RA）。主要结局是患有和未患RA的老年患者的生存率。次要结局是RA亚组中的生存率。在10年随访期间，RA患者的全因死亡率生存率低于非RA患者（分别为53.7%和58.3%，对数秩检验：<0.001）。在全因死亡率RA亚组中，老年发病的RA患者生存结局较差，而年轻发病的RA患者与非RA患者相比生存结局较好（分别为48.1%、73.7%和58.3%，对数秩检验：<0.001）。接受PCI治疗的老年RA患者死亡风险增加，尤其是老年发病而非年轻发病的RA患者。
