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Factors Associated with the Risk of Major Adverse Cardiovascular Events in Patients with Ankylosing Spondylitis: A Nationwide, Population-Based Case—Control Study

Author

Listed:
  • Chung-Mao Kao

    (Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan)

  • Jun-Sing Wang

    (Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
    School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
    College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan)

  • Wei-Li Ho

    (Division of Allergy, Immunology and Rheumatology, Chiayi Branch, Taichung Veterans General Hospital, Chiayi 60090, Taiwan)

  • Tai-Ming Ko

    (Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
    Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
    Institute of Biomedical Sciences, Academia Sinica, Taipei 11529, Taiwan)

  • Hsian-Min Chen

    (Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan
    Center for QUantitative Imaging in Medicine (CQUIM), Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan
    Department of Computer Science and Information Engineering, National United University, Miaoli 36063, Taiwan
    Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan)

  • Ching-Heng Lin

    (Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan
    Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung 40704, Taiwan
    Department of Healthcare Management, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
    Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan)

  • Wen-Nan Huang

    (Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
    School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
    College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan)

  • Yi-Hsing Chen

    (Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
    School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
    College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan)

  • Hsin-Hua Chen

    (Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
    School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
    Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung 40704, Taiwan
    Division of General Internal Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan)

Abstract

Background: Potential risk factors for major adverse cardiovascular events (MACE) in patients with ankylosing spondylitis (AS) requiring medical therapy should be investigated. Methods: We identified newly diagnosed AS patients without previous MACE from 2004 to 2012 using the National Health Insurance Research Database, matched MACE cases with non-MACE controls at a 1:4 ratio for age, gender, AS duration, and index date, and included 947 AS patients with MACE and 3896 matched controls for final analyses. By using conditional logistic regression analyses, we examined the associations of MACE with low income, urbanisation, comorbidities, common extra-articular manifestations (EAM), and medications, including nonsteroidal anti-inflammatory drugs (NSAID) of three categories (traditional NSAIDs, selective cyclooxygenase-2 inhibitors (COX-2i), and preferential COX-2is) with their annual cumulative defined daily dose (cDDD) within a year before MACE development. Results: MACE development was associated with the use of selective COX-2is (especially with annual cDDD > 132) and corticosteroids, residence in rural regions, and well-known associated comorbidities, but not with the use of traditional NSAIDs, preferential COX-2i, biologics, methotrexate, sulfasalazine, and common EAMs. Conclusions: The risk factors of MACE in newly diagnosed AS patients include residence in rural regions, well-known associated comorbidities, and the use of corticosteroids and selective COX-2is. A major limitation was the lack of information on individual lifestyle patterns and disease activity.

Suggested Citation

  • Chung-Mao Kao & Jun-Sing Wang & Wei-Li Ho & Tai-Ming Ko & Hsian-Min Chen & Ching-Heng Lin & Wen-Nan Huang & Yi-Hsing Chen & Hsin-Hua Chen, 2022. "Factors Associated with the Risk of Major Adverse Cardiovascular Events in Patients with Ankylosing Spondylitis: A Nationwide, Population-Based Case—Control Study," IJERPH, MDPI, vol. 19(7), pages 1-13, March.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:7:p:4098-:d:783178
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    References listed on IDEAS

    as
    1. Cossman, J.S. & James, W.L. & Cosby, A.G. & Cossman, R.E., 2010. "Underlying causes of the emerging nonmetropolitan mortality penalty," American Journal of Public Health, American Public Health Association, vol. 100(8), pages 1417-1419.
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