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Patients With Ankylosing Spondylitis Have Increased Cardiovascular and Cerebrovascular Mortality: A Population-Based

Nisha Nigil Haroon, J Michael Paterson, Ping Li

    Annals of Internal Medicine
    |August 11, 2015
    PubMed

    Insights

    Ankylosing spondylitis (AS) patients face a higher risk of cardiovascular and cerebrovascular death. Early screening and management of vascular risk factors are crucial for this population.

    Area of Science:

    • Rheumatology
    • Cardiology
    • Epidemiology

    Background:

    • Ankylosing spondylitis (AS) is a chronic inflammatory spinal arthritis prevalent in young adults.
    • AS is linked to increased cardiovascular and cerebrovascular morbidity.

    Purpose of the Study:

    • To investigate the association between ankylosing spondylitis and the risk of cardiovascular and cerebrovascular mortality.
    • To identify independent risk factors for vascular mortality in AS patients.

    Main Methods:

    • A population-based retrospective cohort study was conducted using administrative health data in Ontario, Canada.
    • 21,473 AS patients were compared with 86,606 matched controls without AS.
    • Vascular death outcomes were analyzed using hazard ratios, adjusted for multiple comorbidities and medications.

    Main Results:

    • Patients with AS exhibited a 36% increased risk of vascular death (HR 1.36, 95% CI 1.13-1.65).
    • Increased risk was observed in men (HR 1.46) but not significantly in women (HR 1.24).
    • Key risk factors included older age, male sex, lower income, dementia, chronic kidney disease, and peripheral vascular disease.

    Conclusions:

    • Ankylosing spondylitis is associated with a significantly elevated risk of vascular mortality.
    • The study highlights the need for comprehensive strategies to screen and manage modifiable vascular risk factors in AS patients.
    • A limitation noted was the lack of validation for AS diagnosis codes in the data source.
    Abstract

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