Outcomes of hospitalizations for myocardial infarctions and cerebrovascular accidents in patients with systemic lupus erythematosus.

Abstract

Patients with systemic lupus erythematosus (SLE) have increased risks of acute myocardial infarction (AMI) and cerebrovascular accident (CVA), but it is not known whether they have worse outcomes after AMI or CVA compared with patients without SLE. This study compared in-hospital mortality, length of stay, and other measures of severity (congestive heart failure or need for coronary artery bypass grafting after AMI; discharge to a skilled nursing facility after CVA) between patients with SLE and patients without SLE who were hospitalized for AMI or CVA. Data on all patients hospitalized in California with either AMI or CVA from 1996 to 2000 were abstracted from a state hospitalization database. Outcomes after AMI were compared between 519 patients with SLE and 214,771 patients without SLE, and outcomes after CVA were compared between 905 patients with SLE and 293,326 patients without SLE. Analyses were performed separately for men and women. Among women with AMI, there were no differences in the risk of in-hospital mortality, long length of stay, or congestive heart failure between patients with SLE and those without SLE, but women with SLE were less likely to undergo coronary artery bypass grafting. Outcomes after AMI did not differ between men with SLE and men without SLE. Among women with CVA, there were no differences in outcomes between patients with SLE and patients without SLE. Men with SLE were almost twice as likely to have a long length of stay after CVA than were men without SLE. Outcomes after AMI and CVA are generally similar between patients with SLE and those without SLE.