Risk of Peripheral Artery Disease and Venous Thromboembolism in Patients with Neuromyelitis Optic Spectrum Disorder:...

The relationship between Neuromyelitis optica spectrum disorder (NMOSD) and specific cardiovascular outcomes, particularly macrovascular events such as peripheral artery disease (PAD) and venous thromboembolism (VTE), has not been examined in a population-based study. The current study investigated the association between NMOSD and the risks of PAD and VTE.

This retrospective cohort study used data from the Taiwan National Health Insurance Research Database. Patients with new-onset NMOSD between 2003 and 2020. Patients with previous PAD or VTE were excluded. Each patient was matched to five general patients for comparison using propensity score matching. In total, the study included 2,027 patients with NMOSD and 10,135 matched general population controls. A Cox proportional hazards model was used to investigate PAD and VTE risk, with relevant variables controlled for. NMOSD was stratified by severity to further verify the association between disease severity and macrovascular event risk. The control variables considered in this study were sex, age, insured salary, urbanization, Charlson comorbidity index (CCI), and related comorbidities.

The average follow-up of all participants was 7.01 person-years. After adjustments for relevant variables, patients with NMOSD had significantly higher risks of PAD (adjusted hazard ratio [aHR] = 1.40; 95% confidence interval [CI]: 1.02-1.92) and VTE (aHR = 4.81; 95% CI: 3.08-7.52). The risk of vascular events was strongly associated with disease severity. Severe NMOSD was associated with markedly increased risks of PAD (aHR = 2.26; 95% CI: 1.41-3.61) and VTE (aHR = 11.69; 95% CI: 6.86-19.90), whereas mild and moderate disease did not significantly increase PAD risk.

NMOSD is a significant risk factor for PAD and VTE. These findings highlight the importance of proactive vascular risk assessment and preventive management in patients with NMOSD.