Ischemic heart disease and ankylosing spondylitis-assessing the role of inflammation.
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.
['Vinker Shuster|Michal|M|', 'Gendelman|Omer|O|', 'Tiosano|Shmuel|S|', 'Comaneshter|Doron|D|', 'Cohen|Arnon D|AD|', 'Amital|Howard|H|']
D000328:Adult D000368:Aged D003430:Cross-Sectional Studies D005260:Female D006801:Humans D007249:Inflammation D008297:Male D008875:Middle Aged D017202:Myocardial Ischemia D012307:Risk Factors D013167:Spondylitis, Ankylosing
Ischemic heart disease Ankylosing spondylitis Risk factors Autoimmunity