Young People with Inflammatory Diseases At More Deadly Risk of Heart Attack: Studies

New studies suggest that heart attacks in young adults are twice as likely to be fatal in people with inflammatory conditions such as psoriasis, lupus, and rheumatoid arthritis.

This study was published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

At least 2% of people in Europe and around the world suffer from systemic inflammatory disease, which often affects multiple organ systems. Many of these systemic inflammatory diseases are caused by autoimmunity. That is, the body’s immune system attacks itself.

Psoriasis is the most common and causes red, itchy, scaly spots on the skin, which can also cause inflammation of the joints. Rheumatoid arthritis causes inflammation of the joints of the limbs and other organ systems. In systemic lupus erythematosus (lupus), the body can attack the skin, joints, kidneys, blood cells, brain, heart, and lungs.

People with systemic inflammatory disease are at increased risk of heart attack. Inflammatory conditions can occur at any age, but onset often occurs in young adulthood. This was the first study to investigate the frequency and effects of inflammatory disease in young heart attack patients.

The study used data from the YOUNG-MI registry that enrolled patients who had a heart attack under the age of 50 between 2000 and 2016 and were treated at Massachusetts General Hospital and Brigham and Women’s Hospital in Boston. .. Researchers have identified patients with systemic inflammatory disease and compared them to patients without these conditions.

Of the 2,097 heart attack patients under the age of 50, 53 (2.5 percent) had inflammatory disease. Psoriasis was the most common (64%), followed by lupus (23%), rheumatoid arthritis (9%) and other symptoms (4%). As expected, patients with inflammatory conditions were more likely to be female. They were also more likely to have high blood pressure, but had the same rate of high cholesterol and diabetes compared to those without inflammatory disease.

During a median follow-up of 11.2 years, inflamed patients were almost twice as likely to die as non-inflamed patients.

The researchers then compared the mortality rates of 53 patients with inflammatory disease to subsamples of 138 patients without these conditions. The two groups were matched for age, gender, and cardiovascular risk factors such as diabetes, obesity, smoking, hypertension, and high cholesterol. Patients with inflammatory disease were 2.68 times more likely to die during the 11.2-year follow-up compared to the corresponding group without inflammatory status.

The study’s author, Brigam and Women’s Hospital, and Dr. Brittany Weber, a cardiac rheumatologist at Harvard Medical School, said: Of other cardiovascular risk factors. “

Although aspirin and statins are recommended after a heart attack, this study found that patients with inflammatory conditions were less likely to be prescribed these drugs at discharge than patients without inflammatory disease. “I was surprised at this discovery,” said Dr. Weber.

“Since these patients often take drugs that suppress the immune system, concerns about drug-drug interactions may be one reason. Systemic inflammatory disease is rare, so in this study The numbers are small and it is important to confirm this result in other similar cohorts, “added Dr. Weber.

Dr. Weber said he needed tools to accurately predict the risk of heart attack in individuals with inflammatory disease in order to target preventative efforts such as statins. “Current calculators used to determine the eligibility of prophylactic drugs generally underestimate the cardiovascular risk of patients with systemic inflammatory response syndrome,” she said.

Dr. Weber said that people with inflammation should follow the same advice as the general public on how to prevent an initial and subsequent heart attack. “Lifestyle behaviors such as healthy eating, physical activity, smoking cessation, and control of cholesterol, blood pressure, and diabetes are very important,” she said.

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