The association between inflammatory joint diseases (IJD) and increased cardiovascular (CV) disease risk, particularly in young populations, is well-established [1,2]. This increased risk results from a complex interplay between systemic inflammation and modifiable CV risk factors that accelerate the atherosclerotic process [3]. Consequently, IJD patients are particularly vulnerable to atherosclerotic CV diseases, such as acute myocardial infarctions (MI), with evidence suggesting poorer outcomes and increased CVD mortality in these patients [3].

It has been suggested that worse CV outcomes observed in patients with rheumatoid arthritis (RA) may be partly attributed to differences in MI presentations, greater myocardial damage, poorer treatment and higher incidences of in-hospital adverse events compared to non-IJD patients [[4], [5], [6], [7], [8]]. However, existing evidence on the clinical courses of RA patients with MI is contradictory. For instance, while some studies report increased rates of atypical MI presentations in RA patients, others report similar symptoms to non-IJD patients [[9], [10], [11]]. Moreover, the literature is divided on whether RA patients with MI differ from others with respect to ST-elevation MI (STEMI) versus non-STEMI (NSTEMI), levels of cardiac troponins, coronary atherosclerotic burden and acute reperfusion therapies [[10], [11], [12], [13], [14], [15], [16], [17], [18], [19],20]. Data on in-hospital complications, short-term mortality and secondary preventive drug prescriptions in RA patients are also inconsistent, showing rates that are higher, similar, or even lower compared to those without RA [10,12,14,15,19,[21], [22], [23], [24], [25]].

While RA patients with MI have been extensively studied, data on those with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) are more limited. Two registry studies indicate similar or reduced short-term mortality following MI in patients with axSpA and PsA [26,27]. Otherwise, there is a scarcity of data regarding the presentation, progression, treatment and complications of MI in these patient groups.

Drawing on data from a comprehensive nationwide Norwegian register, we aimed to compare presenting symptoms, myocardial damage, acute treatment, in-hospital adverse events, short-term outcomes and secondary cardio-preventive drugs in patients with RA, axSpA and PsA experiencing their first MI versus patients without IJD.