Piplani Shobhit, Kostojchin Anastas, Kong Steve, Sharma Aakanksha, Brown Donclair, Jelic Vladimir, Chaturvedi Salil, Reddy Vishal, Chang Pieri Katherine, Akpan Ezekiel, Simpson Tamara, Xiao Wenzhen, Sakellakis Minas, Sharma Aayushi, Jain Priyanshu, Radulovic Miroslav
Jacobi Medical Center/North Central Bronx, Albert Einstein College of Medicine, NYC Health and Hospitals, 3424 Kossuth Avenue, Bronx, NY, 10467, USA.
Department of Cardiology North Central Bronx Hospital/VA Medical Center, Icahn School of Mount Sinai, 3424 Kossuth Avenue, Bronx, NY, 10467, USA.
Indian Heart J. 2025 Jan-Feb;77(1):7-13. doi: 10.1016/j.ihj.2024.12.002. Epub 2024 Dec 20.
The present study aims to investigate the outcomes of Percutaneous coronary intervention (PCI) in patients with Rheumatoid arthritis (RA).
A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to 15th September 2023. All statistical analyses were conducted using Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported in the odds ratio (OR) and the corresponding 95 % confidence interval (CI).
Eight observational studies were selected to conduct the analysis. A statistically significant increase in major adverse cardiovascular event (MACE) was seen in RA patients after undergoing PCI as compared to the control group (OR = 1.18 (1.16, 1.21); p < 0.00001; I2 = 0 %). There was no significant difference found in the long-term revascularization outcome between the RA and non-RA patients (OR = 1.18 (0.81, 1.71); p = 0.39; I2 = 93 %). Survival rates of all-cause mortality in the long-term outcome were statistically insignificant among the two groups (OR = 1.21 (0.84, 1.74); p = 0.31; I2 = 99 %).
Percutaneous coronary intervention is an important intervention to reduce morbidity and mortality but special precautions and attention should be made when it comes to patients with RA. Different precautions such as close monitoring for medication interaction, and tailored post-procedural care are essential in reducing morbidity and mortality.
本研究旨在调查类风湿关节炎（RA）患者经皮冠状动脉介入治疗（PCI）的结果。
从电子数据库（PubMed/Medline、Cochrane图书馆和谷歌学术）自创建至2023年9月15日进行系统检索。所有统计分析均使用Review Manager 5.4.1进行。选择符合纳入标准的研究。当存在异质性时，使用随机效应模型对研究进行汇总，结果以比值比（OR）和相应的95%置信区间（CI）报告。
选择八项观察性研究进行分析。与对照组相比，RA患者接受PCI后主要不良心血管事件（MACE）有统计学意义的增加（OR = 1.18（1.16，1.21）；p < 0.00001；I2 = 0%）。RA患者和非RA患者之间的长期血运重建结果无显著差异（OR = 1.18（0.81，1.71）；p = 0.39；I2 = 93%）。两组长期全因死亡率的生存率无统计学意义（OR = 1.21（0.84，1.74）；p = 0.31；I2 = 99%）。
经皮冠状动脉介入治疗是降低发病率和死亡率的重要干预措施，但对于RA患者应采取特殊预防措施并予以关注。不同的预防措施，如密切监测药物相互作用和量身定制的术后护理，对于降低发病率和死亡率至关重要。
