ACS patients with SLE require greater healthcare use

Systemic lupus erythematosus (SLE) patients with acute coronary syndrome (ACS) need a longer hospital stay and accrue higher charges, resulting in higher healthcare utilization, reports a study.

A team of investigators examined trends in ACS hospitalizations among patients with SLE and compared outcomes and healthcare utilization between ACS patients with and without SLE using data from the US National Inpatient Sample from 2006 to 2019. They classified ACS hospitalizations by the presence or absence of SLE using ICD 9th and 10th revisions codes.

Finally, the investigators used chi-square and t tests to examine the associations with SLE for categorical and continuous variables, respectively.

A total of 17,318,554 ACS hospitalizations were identified, of which 70,882 involved patients with SLE. Those with SLE were more often <50 years of age, female, Black, and had higher rates of antiphospholipid syndrome, chronic and end-stage kidney disease, and prior thromboembolism.

ACS hospitalization rates from 2006 to 2019 saw a 40-percent reduction among SLE patients (mainly from 2015 to 2019) and a 50-percent decrease among those without SLE. In-hospital mortality was comparable (7 percent vs 6.9 percent; p=0.52), but patients with SLE had longer hospital stays 96.22 vs 5.51 days; p<0.001) and higher charges (USD 79,909 vs 74,294; p<0.001).

“Although ACS hospitalization rates declined for both groups, the decrease was greater in patients without SLE,” the investigators said.

“These findings underscore the need for continuous targeted cardiovascular risk management strategies in patients with SLE to reduce morbidity and healthcare burden,” they added.