BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory arthritis affecting the spine in young adults. It is associated with excess cardiovascular and cerebrovascular morbidity. OBJECTIVE: To determine whether patients with AS are at increased risk for cardiovascular and cerebrovascular mortality. DESIGN: Population-based retrospective cohort study using administrative health data. SETTING: Ontario, Canada. PATIENTS: 21 473 patients with AS aged 15 years or older and 86 606 comparators without AS, matched for age, sex, and location of residence. MEASUREMENTS: The primary outcome was a composite of cardiovascular and cerebrovascular death. Hazard ratios (HRs) for vascular death were calculated; adjusted for history of cancer, diabetes, dementia, inflammatory bowel disease, hypertension, chronic kidney disease, and peripheral vascular disease; and, among those aged 66 years or older, relevant drug therapies. Independent risk factors for vascular mortality were identified in patients with AS. RESULTS: The mean age of patients with AS was 46 years, and 53% were male. Patients and comparators were followed for 166 920 and 686 461 patient-years, respectively. Adjusted HRs for vascular death in AS were 1.36 (95% CI, 1.13 to 1.65) overall, 1.46 (CI, 1.13 to 1.87) in men, and 1.24 (CI, 0.92 to 1.67) in women. Significant risk factors for vascular death were age; male sex; lower income; dementia; chronic kidney disease; peripheral vascular disease; and, among patients aged 65 years or older, lack of exposure to nonsteroidal anti-inflammatory drugs and statins. LIMITATION: Diagnosis codes for AS were not validated in Ontario. CONCLUSION: Ankylosing spondylitis is associated with increased risk for vascular mortality. A comprehensive strategy to screen and treat modifiable vascular risk factors in AS is needed. PRIMARY FUNDING SOURCE: The Arthritis Program, University Health Network, Toronto; and The Arthritis Society, Canada.
BACKGROUND:Ankylosing spondylitis (AS) is a chronic inflammatory arthritis affecting the spine in young adults. It is associated with excess cardiovascular and cerebrovascular morbidity. OBJECTIVE: To determine whether patients with AS are at increased risk for cardiovascular and cerebrovascular mortality. DESIGN: Population-based retrospective cohort study using administrative health data. SETTING: Ontario, Canada. PATIENTS: 21 473 patients with AS aged 15 years or older and 86 606 comparators without AS, matched for age, sex, and location of residence. MEASUREMENTS: The primary outcome was a composite of cardiovascular and cerebrovascular death. Hazard ratios (HRs) for vascular death were calculated; adjusted for history of cancer, diabetes, dementia, inflammatory bowel disease, hypertension, chronic kidney disease, and peripheral vascular disease; and, among those aged 66 years or older, relevant drug therapies. Independent risk factors for vascular mortality were identified in patients with AS. RESULTS: The mean age of patients with AS was 46 years, and 53% were male. Patients and comparators were followed for 166 920 and 686 461 patient-years, respectively. Adjusted HRs for vascular death in AS were 1.36 (95% CI, 1.13 to 1.65) overall, 1.46 (CI, 1.13 to 1.87) in men, and 1.24 (CI, 0.92 to 1.67) in women. Significant risk factors for vascular death were age; male sex; lower income; dementia; chronic kidney disease; peripheral vascular disease; and, among patients aged 65 years or older, lack of exposure to nonsteroidal anti-inflammatory drugs and statins. LIMITATION: Diagnosis codes for AS were not validated in Ontario. CONCLUSION:Ankylosing spondylitis is associated with increased risk for vascular mortality. A comprehensive strategy to screen and treat modifiable vascular risk factors in AS is needed. PRIMARY FUNDING SOURCE: The Arthritis Program, University Health Network, Toronto; and The Arthritis Society, Canada.
Authors: Jürgen Braun; Klaus Krüger; Bernhard Manger; Matthias Schneider; Christof Specker; Hans Joachim Trappe Journal: Dtsch Arztebl Int Date: 2017-03-24 Impact factor: 5.594
Authors: Katherine D Wysham; Sara G Murray; Nancy Hills; Edward Yelin; Lianne S Gensler Journal: Arthritis Care Res (Hoboken) Date: 2017-02 Impact factor: 4.794
Authors: F Proft; H Schulze-Koops; M Grunke; E Schrezenmeier; F Halleck; J Henes; L Unger; E Schmidt; C Fiehn; A Jacobi; C Iking-Konert; C Kneitz; R E Schmidt; B Bannert; R E Voll; R Fischer-Betz; I Kötter; H P Tony; J Holle; M Aringer; A Erler; F Behrens; G R Burmester; T Dörner Journal: Z Rheumatol Date: 2018-02 Impact factor: 1.372
Authors: P Stefan Biesbroek; Sjoerd C Heslinga; Peter M van de Ven; Mike J L Peters; Raquel P Amier; Thelma C Konings; Christopher D Maroules; Colby Ayers; Parag H Joshi; Irene E van der Horst-Bruinsma; Vokko P van Halm; Albert C van Rossum; Michael T Nurmohamed; Robin Nijveldt Journal: Clin Rheumatol Date: 2018-05-12 Impact factor: 2.980