Is there an association between anti-inflammatory medical treatments for rheumatoid arthritis and mortality after first myocardial infarction?
Authors' conclusion
Anti-inflammatory treatment was not associated with mortality within 30 days after a first AMI. From 31 to 365 days post-AMI, corticosteroid treatment was associated with increased mortality risk for all patients, and csDMARDs and anti-TNFs were associated with increased survival for RA patients.
Study context
- Population
- Patients with a first acute myocardial infarction (AMI) during 2006–2017, Swedish registries; drugs categorised as corticosteroids, NSAIDs, csDMARDs, anti-TNFs or other bDMARDs3,725 rheumatoid arthritis (RA) patients
- Participants
- 199,071 patients
- Exposure
- Anti-inflammatory treatment in the 6 months before a first AMI vs no such treatment, in patients with and without RA
- RAn = 3,725
- Outcome
- Mortality (survival) after first AMI by anti-inflammatory treatment
- Follow-up
- Up to 365 days post-AMI
Methodological detailsSwedish registries, multivariable logistic regression (≤30 days), multivariable Cox proportional hazard models (31–365 days)
- Swedish registries
- Multivariable logistic regression (≤30 days)
- Multivariable Cox proportional hazard models (31–365 days)
Main finding
As reported in the abstract
Mortality, 31 to 365 days post-AMI
Hazard ratio (95% CI)
Corticosteroids (RA)increased mortality
1.43(1.27–1.62)
Corticosteroids (without RA)increased mortality
1.37(1.33–1.41)
csDMARDs (RA)increased survival
0.86(0.78–0.96)
Anti-TNFs (RA)increased survival
0.72(0.56–0.94)
csDMARDs (without RA)increased mortality
1.14(1.04–1.24)
Observational data: associations, not effects.
Further findings
- No treatment was associated with survival within 30 days after the AMI
Original publication
Is there an association between anti-inflammatory medical treatments for rheumatoid arthritis and mortality after first myocardial infarction? Scand J Rheumatol. Published 29 August 2025. doi:10.
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