Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study

Area of Science:

• Cardiology
• Rheumatology
• Epidemiology

Background:

• Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) is a systemic autoimmune disease.
• Cardiovascular complications, including myocardial infarction (MI), are a concern in AAV patients.
• The precise incidence and risk factors for MI in AAV are not fully elucidated.

Purpose of the Study:

• To determine the incidence rate (IR) of MI in patients with AAV.
• To identify predictors of MI in AAV patients.
• To compare the MI incidence in AAV patients to the general population using an incidence rate ratio (IRR).

Main Methods:

• A cohort of 325 patients diagnosed with AAV between 1997 and 2016 in Skåne, Sweden, was analyzed.
• Patients were matched with 10 reference subjects from the general population.
• MI events were identified using national healthcare registers, and Cox regression was used to analyze predictors.

Main Results:

• The incidence rate of MI in AAV patients was 1.6 per 100 person-years.
• The incidence rate ratio (IRR) of MI in AAV patients compared to the background population was 1.9.
• MI risk was highest in the first 3 months post-diagnosis, in patients with myeloperoxidase-ANCA+ disease, and those with high disease activity at diagnosis. Age at diagnosis was an independent predictor.

Conclusions:

• Individuals with AAV experience a higher incidence of MI than the general population.
• Disease severity and the period immediately following diagnosis are critical factors influencing MI risk in AAV.
• Age at diagnosis is the primary independent predictor for MI in this AAV cohort.