TOPLINE

Patients with systemic lupus erythematosus (SLE) who experienced an acute myocardial infarction (MI) had significantly higher risks for all-cause and cardiovascular mortality for up to 5 years than those without SLE.

METHODOLOGY

• Researchers conducted a retrospective cohort study using registry data from England and Wales to compare long-term all-cause and cardiovascular mortality after acute MI in patients with vs without SLE.
• They included 784,091 patients hospitalised with acute MI between January 2005 and March 2019. The median follow-up duration was 6.1 years.
• The primary outcome was all-cause mortality at 30 days and 1 and 5 years, as well as over the entire study period. The researchers also assessed cardiovascular mortality.
• Secondary outcomes were quality-of-care measures such as opportunity-based quality indicators (OBQIs), including the discharge prescription of aspirin, statins, angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), and cardiac rehabilitation referral.

TAKEAWAY

• Overall, 0.1% of patients with acute MI had SLE. Patients with SLE were younger (median age, 63.9 vs 70.3 years) and more often women (76% vs 34%) than those without (P < .001 for both).
• The adjusted risk for all-cause mortality after acute MI was higher among patients with vs without SLE by 62% at 30 days, 77% at 1 year, and 84% at 5 years (P ≤ .001 for all).
• Patients with SLE had a 63%-75% higher risk for cardiovascular mortality than those without SLE at 30 days and 1 and 5 years (P < .01 for all).
• Patients with vs without SLE were less likely to be prescribed aspirin, statins, and ACE inhibitors/ARBs at discharge and had a slightly lower mean OBQI score (P < .05 for all). Rates of coronary angiography and revascularisation did not differ significantly.

IN PRACTICE

"[The] findings highlight SLE as an independent determinant of adverse long-term cardiovascular outcomes and underscore the importance of early recognition, rigorous secondary prevention, and coordinated cardiology-rheumatology care to mitigate ongoing risk in this vulnerable population," the authors wrote.

SOURCE

The study was led by Kian Kermani, Keele University, Stoke-on-Trent, England. It was published online on July 11, 2026, in Rheumatology.

LIMITATIONS

The study lacked details on frailty, treatment decisions, angiographic findings, and some comorbidities. Data on the duration of SLE, disease activity, and treatment were unavailable. Residual confounding could not be excluded.

DISCLOSURES

The study received funding from the National Institute for Health and Care Research Birmingham Biomedical Research Centre. One author reported receiving research fellowship salary from Abbott Vascular.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.