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Myocardial infarction in a population-based cohort of patients with biopsy-confirmed giant cell arteritis in southern Sweden

Stamatis, Pavlos LU orcid ; Mohammad, Moman Aladdin LU ; Gisslander, Karl LU orcid ; Merkel, Peter A. ; Englund, Martin LU orcid ; Turesson, Carl LU ; Erlinge, David LU orcid and Mohammad, Aladdin J. LU (2024) In RMD Open 10(2).
Abstract

Objectives To determine the incidence rate (IR) of myocardial infarction (MI), relative risk of MI, and impact of incident MI on mortality in individuals with biopsy-confirmed giant cell arteritis (GCA). Methods MIs in individuals diagnosed with GCA 1998-2016 in Skåne, Sweden were identified by searching the SWEDEHEART register, a record of all patients receiving care for MI in a coronary care unit (CCU). The regional diagnosis database, with subsequent case review, identified GCA patients receiving care for MI outside of a CCU. A cohort of 10 reference subjects for each GCA case, matched for age, sex and area of residence, was used to calculate the incidence rate ratio (IRR) of MI in GCA to that in the general population. Results The... (More)

Objectives To determine the incidence rate (IR) of myocardial infarction (MI), relative risk of MI, and impact of incident MI on mortality in individuals with biopsy-confirmed giant cell arteritis (GCA). Methods MIs in individuals diagnosed with GCA 1998-2016 in Skåne, Sweden were identified by searching the SWEDEHEART register, a record of all patients receiving care for MI in a coronary care unit (CCU). The regional diagnosis database, with subsequent case review, identified GCA patients receiving care for MI outside of a CCU. A cohort of 10 reference subjects for each GCA case, matched for age, sex and area of residence, was used to calculate the incidence rate ratio (IRR) of MI in GCA to that in the general population. Results The GCA cohort comprised 1134 individuals. During 7958 person-years of follow-up, 102 were diagnosed with incident MI, yielding an IR of 12.8 per 1000 person-years (95% CI 10.3 to 15.3). The IR was highest in the 30 days following GCA diagnosis and declined thereafter. The IRR of MI in GCA to that of the background population was 1.29 (95% CI 1.05 to 1.59). Mortality was higher in GCA patients who experienced incident MI than in those without MI (HR 2.8; 95% CI 2.2 to 3.6). Conclusions The highest incidence of MI occurs within the 30 days following diagnosis of GCA. Individuals with GCA have a moderately increased risk of MI compared with a reference population. Incident MI has a major impact on mortality in GCA.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular Diseases, Giant Cell Arteritis, Incidence, Mortality, Vasculitis
in
RMD Open
volume
10
issue
2
article number
e003960
publisher
BMJ Publishing Group
external identifiers
  • pmid:38599652
  • scopus:85190360681
ISSN
2056-5933
DOI
10.1136/rmdopen-2023-003960
language
English
LU publication?
yes
id
0a59cf00-f1ee-4e35-a905-481a961c159b
date added to LUP
2024-05-14 15:17:10
date last changed
2024-05-15 03:02:36
@article{0a59cf00-f1ee-4e35-a905-481a961c159b,
  abstract     = {{<p>Objectives To determine the incidence rate (IR) of myocardial infarction (MI), relative risk of MI, and impact of incident MI on mortality in individuals with biopsy-confirmed giant cell arteritis (GCA). Methods MIs in individuals diagnosed with GCA 1998-2016 in Skåne, Sweden were identified by searching the SWEDEHEART register, a record of all patients receiving care for MI in a coronary care unit (CCU). The regional diagnosis database, with subsequent case review, identified GCA patients receiving care for MI outside of a CCU. A cohort of 10 reference subjects for each GCA case, matched for age, sex and area of residence, was used to calculate the incidence rate ratio (IRR) of MI in GCA to that in the general population. Results The GCA cohort comprised 1134 individuals. During 7958 person-years of follow-up, 102 were diagnosed with incident MI, yielding an IR of 12.8 per 1000 person-years (95% CI 10.3 to 15.3). The IR was highest in the 30 days following GCA diagnosis and declined thereafter. The IRR of MI in GCA to that of the background population was 1.29 (95% CI 1.05 to 1.59). Mortality was higher in GCA patients who experienced incident MI than in those without MI (HR 2.8; 95% CI 2.2 to 3.6). Conclusions The highest incidence of MI occurs within the 30 days following diagnosis of GCA. Individuals with GCA have a moderately increased risk of MI compared with a reference population. Incident MI has a major impact on mortality in GCA.</p>}},
  author       = {{Stamatis, Pavlos and Mohammad, Moman Aladdin and Gisslander, Karl and Merkel, Peter A. and Englund, Martin and Turesson, Carl and Erlinge, David and Mohammad, Aladdin J.}},
  issn         = {{2056-5933}},
  keywords     = {{Cardiovascular Diseases; Giant Cell Arteritis; Incidence; Mortality; Vasculitis}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{2}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{RMD Open}},
  title        = {{Myocardial infarction in a population-based cohort of patients with biopsy-confirmed giant cell arteritis in southern Sweden}},
  url          = {{http://dx.doi.org/10.1136/rmdopen-2023-003960}},
  doi          = {{10.1136/rmdopen-2023-003960}},
  volume       = {{10}},
  year         = {{2024}},
}