After adjusting for potential confounders, endophthalmitis increases the risk for acute myocardial infarction (MI) in patients with ankylosing spondylitis (AS), according to study findings published in the Journal of Clinical Medicine.
Research has shown that cardiovascular events (CV) have been linked to the development of endophthalmitis among patients with AS.
The researchers sought to assess the association between endophthalmitis and the risk for acute MI in patients with AS, using a nationwide population-based Taiwanese database called the Longitudinal Health Insurance Database (LHID).
Patients who were diagnosed with AS at least 1 time during hospitalization and more than 3 times during outpatient visits were included in the study. Patient comorbidities were recorded at baseline and at the study endpoint.
A comorbidity was defined as receiving the same diagnosis at at least 3 medical visits within a year before the inclusion date or the date of the study endpoint. The Charlson comorbidity index revised score (CCI_R) was evaluated as well.
Of the 1,914,201 individuals registered in the Taiwan LHID, 19,996 patients with AS were included in the study, with 557 having endophthalmitis. The comparison cohort included 2228 patients with AS without endophthalmitis, who were matched for age, sex, comorbidities, and inclusion date with the study cohort.
At baseline, the mean patient age in the 2 cohorts was 37.72±18.92 years, and 55.12% were men. At study conclusion, 12.39% (n=69/557) of participants in the study cohort and 8.66% (n=193/2228) of those in the comparison cohort, respectively, reported experiencing an acute MI (hazard ratio, 1.631; P <.001).
Further, participants in the study vs comparison cohort reported higher rates of diabetes, hyperlipidemia, hypertension, congestive heart failure, chronic obstructive pulmonary disease, asthma, as well as higher CCI_R scores. With an average follow-up of 9.91±8.57 years, researchers did not observe a difference in patients with AS with and those without endophthalmitis.
Study limitations included the retrospective design, the use of medical records from a nationwide database, and the inability to determine a causal relationship between endophthalmitis and incidence of acute MI in patients with AS. In addition, the study results might not be generalizable to other populations.
The researchers concluded, “Based on our study results, special attention and work-up are required for physicians when encountering a history of endophthalmitis in these special patient populations, especially when they are comorbid with other potential CV risk factors.”
Lin T-Y, Lai Y-F, Chien W-C, et al. Impact of endophthalmitis on the risk of acute myocardial infarction in ankylosing spondylitis patients: a population-based retrospective cohort study. J Clin Med. 2023;12(3):1211. doi:10.3390/jcm12031211