Ischemic heart disease and ankylosing spondylitis—assessing the role of inflammation
- 22 February 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in Clinical Rheumatology
- Vol. 37 (4), 1053-1058
- https://doi.org/10.1007/s10067-018-4037-y
Abstract
To assess the association of ankylosing spondylitis (AS) and ischemic heart disease (IHD) compared to traditional cardiovascular (CV) risk factors. Primary care and hospital records of patients with AS were analyzed, using the largest health maintenance organization in Israel, the “Clalit” Health Services data. These patients were compared with age- and gender-matched controls regarding the proportion of IHD in a cross-sectional study. Parameters including socioeconomic status, body mass index (BMI), smoking habits, and coexistent medical conditions hypertension, hyperlipidemia, and diabetes mellitus (DM) - as well as the use of NSAIDs and anti-TNFs were also assessed. The study included 4076 AS patients compared to 20,290 age- and gender-matched controls without AS. The proportion of IHD was higher among AS patients as compared to controls (14.1 vs. 6.36%, respectively, p < 0.01) and patients treated with anti-TNFs had a lower risk for IHD compared to non-anti-TNF users. The proportion of hypertension, hyperlipidemia, DM, and smoking was also higher among AS patients. However, in multivariate analyses following adjustment to these risk factors, AS was not found to be associated with IHD nor anti-TNF therapy to be a protective factor. Patients with AS have more traditional CV risk factors, thus are in a higher risk for IHD. AS itself was not shown to be independently associated with IHD. These findings emphasize the multifactorial process leading to increased proportion of IHD among AS patients and the need for a stringent control of traditional risk factors in these patients.Keywords
This publication has 46 references indexed in Scilit:
- Cardiovascular risk profile in patients with spondyloarthritisJoint Bone Spine, 2014
- Microtubule-Associated Type II Protein Kinase A Is Important for Neurite ElongationPLOS ONE, 2013
- Increased Risk of Ischemic Heart Disease in Young Patients with Newly Diagnosed Ankylosing Spondylitis – A Population-Based Longitudinal Follow-Up StudyPLOS ONE, 2013
- Anti-tumor necrosis factor therapy improves insulin resistance, beta cell function and insulin signaling in active rheumatoid arthritis patients with high insulin resistanceArthritis Research & Therapy, 2012
- Cardiovascular Risk with Non-Steroidal Anti-Inflammatory Drugs: Systematic Review of Population-Based Controlled Observational StudiesPLoS Medicine, 2011
- Cardiopulmonary Manifestations of Ankylosing SpondylitisInternational Journal of Rheumatology, 2011
- EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritisAnnals Of The Rheumatic Diseases, 2009
- Subclinical Atherosclerosis in Rheumatoid Arthritis and Systemic Lupus ErythematosusAmerican Journal Of Medicine, 2008
- High prevalence of metabolic syndrome in patients with ankylosing spondylitisClinical Rheumatology, 2006
- Cardiovascular risk parameters in men with ankylosing spondylitis in comparison with non-inflammatory control subjects: relevance of systemic inflammationClinical Science, 2005