Mortality Rates After Coronary Revascularization Procedures Among Systemic Lupus Erythematosus Compared to Diabetes Mellitus and General Population Medicaid Patients
Despite similar myocardial infarction risks in individuals with systemic lupus erythematosus (SLE) and those with diabetes mellitus (DM), SLE patients enrolled in Medicaid have substantially higher rates of coronary revascularization procedures (including coronary artery bypass grafting or percutaneous coronary intervention) compared to age- and sex-matched DM patients. Researchers evaluated 30-day mortality rates following coronary revascularization procedures among 608 SLE compared to 1,185 DM and 628 general population patients enrolled in Medicaid. Although based on a small number of post-procedural deaths in each of the groups, investigators found that SLE patients had 1.7 times higher 30-day mortality rates after coronary revascularization compared to DM and general population patients, despite being on average much younger when they had the procedure. After adjusting for demographics and comorbid index lupus patients had double the odds of death within 30 days after a coronary revascularization compared to patients with DM. They also found a similar, but non-significant result for SLE patients compared to the general population, although this was limited by very few deaths in the general population group. The researchers wrote that “future studies accounting for healthcare utilization, the complexity and indications of the procedures performed, SLE and cardiac disease severity, and investigating causes of post-procedure deaths are required.”
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the tenth consecutive year), No. 3 in rheumatology by U.S. News & World Report (2019-2020), and named a leader in pediatric orthopedics by U.S. News & World Report “Best Children’s Hospitals” list (2019-2020). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 130 countries. Through HSS Global Ventures, the institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.