Myocardial infarction glucocorticoids

This report highlights the risk of cardiovascular adverse effects with short courses of glucocorticoid therapy in elderly patients with inflammatory bowel disease, even with rather low-dosage regimens. Acute myocardial infarction occurred in an old man with coronary insufficiency and giant cell arteritis after treatment with prednisolone (SEDA-10, 343) but could well have been coincidental. 

Patients with seropositive rheumatoid arthritis taking long-term systemic glucocorticoids are at risk of accelerated cardiac rupture in the setting of transmural acute myocardial infarction treated with thrombolytic drugs (25). 

Cardiovascular The use of glucocorticoids is associated with increased risks of myocardial infarction, stroke, and heart failure, but data are limited on the risk of atrial fibrillation and atrial flutter. In a case-control study patients with a first hospital diagnosis of atrial fibrillation or flutter were identified in Northern Denmark p "]. For each case 10 population controls matched by age and sex were selected. 

In a large observational study (n = 507966) patients who had recently started asthma medication (SABA, LABA, inhaled glucocorticoids) were at an initial increased risk of myocardial infarction, particularly in the first 3 months, which then fell there was no significant difference in the risk between treatments (RRs SABA = 2.4, LABA = 1.5, inhaled glucocorticoids = 1.5) [39 ]. Heavy long-term use (more than 13 prescriptions in 1 year) of an inhaled glucocorticoid and a SABA was also associated with an increased risk of myocardial infarction. Limitations of this study included potential confounders and the possibility that inhalers are sometimes incorrectly given for cardiac asthma (i.e. pulmonary edema). 

Avifta-Zubieta JA, Abrahamowicz M, De Vera MA, Choi HK, Sayre EC, Rahman MM, et al. Immediate and past cumulative effects of oral glucocorticoids on the risk of acute myocardial infarction in rheumatoid arthritis a population-based study. Rheumatology (Oxford) 2013 52(l) 68-75. 

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