Ankylosing spondylitis (AS) is a form of chronic inflammatory arthritis that predominantly affects the spine. In addition to suffering from chronic lower back pain, patients with AS are at increased risk for heart disease and stroke. Coronary artery disease and heart attacks occur at a much higher rate in these patients, and AS has been shown to be an independent risk factor for coronary artery bypass graft surgery. Whether this translates to an increased risk of cardiovascular-related death is not known.
A recent study, led by TWRI Affiliate Scientist Dr. Nigil Haroon and his team, assessed whether patients with AS are at increased risk for mortality due to cardiovascular and cerebrovascular disease (vascular death). By analyzing the administrative health data of over 21,000 patients, they found that patients with AS were at significantly higher risk for vascular death than those without the disease. Major risk factors for death included age, chronic kidney disease and lack of exposure to nonsteroidal anti-inflammatory drugs. Moreover, male patients with AS had significantly higher mortality—whether this indicates that inflammation is less severe or that the disease is milder in women is not known.
"These findings indicate that a comprehensive strategy to screen and treat modifiable risk factors for vascular disease in patients with AS is needed," says Dr. Haroon. "Further investigation is required to study the effect of therapeutic interventions in preventing the elevated vascular mortality in these patients."
This work was supported by The Arthritis Society, the UHN Arthritis Program, the Ministry of Health and Long-term Care, and the Toronto General & Western Hospital Foundation.
Patients with ankylosing spondylitis have increased cardiovascular and cerebrovascular mortality: a population-based study. Haroon NN, Paterson JM, Inman RD and Haroon N. Annals of Internal Medicine. 2015 Aug. [Pubmed abstract]