Ankylosing spondylitis and risk of ischaemic heart disease: a population-based cohort study

I. Essers, C. Stolwijk, A. Boonen, M.L. de Bruin, M.T. Bazelier, F. de Vries, A. van Tubergen

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Abstract

Objective To investigate the incidence and risk of ischaemic heart disease (IHD) and acute myocardial infarction (AMI), including the role of non-steroidal anti-inflammatory drugs (NSAID), in patients with ankylosing spondylitis (AS) compared with population controls.
Methods All patients with newly diagnosed AS (n=3809) from the British Clinical Practice Research Datalink (1987–2012) were matched with up to seven persons without AS by year of birth, gender and practice (n=26 197). Incidence rate ratios (IRR) and HRs for development of IHD and AMI were calculated. Stepwise analyses were performed adjusting for age, gender, comorbidity and drug use, including NSAIDs.
Results At baseline, 4.3% of the patients had IHD and 1.8% had AMI compared with 3.4% and 1.4% of the controls, respectively. After exclusion of pre-existing IHD or AMI, the IRRs were 1.18 (95% CI 0.96 to 1.46) and 0.91 (95% CI 0.65 to 1.27) for IHD and AMI, respectively. Compared with controls, the age-gender adjusted HR for developing IHD was 1.20 (95% CI 0.97 to 1.48), and for AMI 0.91 (95% CI 0.65 to 1.28). In female patients, the risk of developing IHD was increased (HR 1.88, 95% CI 1.22 to 2.90), but after adjustment for all possible risk factors only a non-significant trend was found (HR 1.31, 95% CI 0.83 to 2.08). In particular, NSAID use explained this change (HR IHD adjusted for age-gender-NSAID use 1.57, 95% CI 0.99 to 2.48).
Conclusions Female patients with AS had an increased age-adjusted risk of developing IHD, but after adjustment for NSAID use only a non-significant trend towards increased risk was found.
Original languageEnglish
Pages (from-to)203-209
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume75
Issue number1
Early online date31 Oct 2014
DOIs
Publication statusPublished - 1 Jan 2016

Keywords

  • NONSTEROIDAL ANTIINFLAMMATORY DRUGS
  • ACUTE MYOCARDIAL-INFARCTION
  • RHEUMATOID-ARTHRITIS
  • CARDIOVASCULAR RISK
  • PSORIATIC-ARTHRITIS
  • MORTALITY
  • VALIDITY
  • PROFILE
  • WOMEN

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