This article is part of Rheumatology Advisor’s 2017 in-depth coverage of ACR, which took place in San Diego, CA. Our staff will be reporting on the latest treatment advancements and research initiatives for spondyloarthritis. Click here to read more of Rheumatology Advisor‘s conference coverage.

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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Reference

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.