Ankylosing Spondylitis Associated With Higher Risk for Cardiovascular Events

The risk for cerebrovascular accidents and myocardial infarctions was assessed in patients with ankylosing spondylitis.
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SAN DIEGO — Patients with ankylosing spondylitis (AS) tend to present with a greater risk for cerebrovascular accidents (CVA) compared with patients without AS, according to a study presented at the American College of Rheumatology 2017 Annual Meeting, held November 3-8 in San Diego, California.

“There is conflicting data on the risk of myocardial infarction (MI) and [CVA] in patients with [AS],” according to the study investigators.

This retrospective study included patients with incident AS with a total of 2 International Statistical Classification of Diseases and Related Health Problems, Ninth Revision (ICD-9), or ICD-10 codes for AS ≥2 months apart and within a 2-year timeframe. In addition, cases of AS were considered incident AS if they featured a 7-year run-in duration before the first AS ICD code.

A total of 7190 patients with AS were identified in the final analysis. Of these, 7148 did not have a history of CVA, and 7107 were free from previous MI. During the study, CVA and MI occurred in 80 (incidence rate, 1.8/1000 patient years) and 115 (incidence rate, 2.6/1000 patient years) patients, respectively. Matched risk ratios for CVA and MI were 1.60 (95% confidence interval [CI], 1.25-2.03) and 1.52 (95% CI, 1.24-1.85), respectively.

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Researchers also adjusted for previous or current cardiovascular risk factors, including angina; obesity; and use of oral glucocorticoids and/or cardiovascular drugs, statins, and nonsteroidal anti-inflammatory drugs. After adjustment, the risk ratios for a CVA or MI were 1.34 (95% CI, 1.04-1.73) and 1.21 (95% CI, 0.98-1.49), respectively.

According to the investigators, this study supports “increased monitoring for this potentially fatal outcome and its modifiable risk factors…for AS patients.”

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So A, Chan J, Sayre EC, Avina-Zubieta JA, et al. Risk of myocardial infarction and cerebrovascular accident in ankylosing spondylitis: a general population-based study. Presented at: American College of Rheumatology (ACR)/Association of Rheumatology Health Professionals (ARHP) 2017 Annual Meeting; November 3-8, 2017; San Diego, California. Abstract 2972.