Previous studies have shown that if you’re living with ankylosing spondylitis your vascular system (the arteries and veins that transport blood throughout the body) is at greater risk of developing disease. A new study however suggests that AS patients are also at greater risk of mortality should they develop vascular disease or experience a vascular event.
The researchers utilized data from four different Canadian registries, identifying a study cohort of 21,473 patients with AS age 15 and older. (Patients with baseline coronary artery disease or cerebrovascular disease were excluded from the study cohort.) The AS patients were compared to 86,606 persons without AS, and matched for age, sex, and location of residence.
“Recent evidence suggests that patients with AS have increased risk of vascular disease such as coronary heart disease. Our study not only strengthens this data but also provides new information that mortality after a vascular event is higher in AS patients. Further, our results suggest that vascular mortality is directly linked to AS (as comorbidities were controlled for),” said senior study author, and the 2013 recipient of SAA’s Young Investigator Award, Nigil Haroon, MD, PhD, DM.
The researchers found that patients with AS had a 43% higher risk for vascular mortality, a 60% higher risk for cerebrovascular mortality, and a 35% higher risk for cardiovascular mortality than those without AS studied for comparison. A difference in the vascular death rate was also noted between men and women who had AS – with men with AS having a 50% higher risk than men without AS, and women with AS having a 34% higher risk than women without AS. Also, with each year of advancing age the risk for vascular mortality increased by 12%.
According to Dr. Haroon, “The major clinical implication of the study is that patients with AS should be screened and closely monitored for the prevention, early diagnosis, and treatment of cardiac and coronary events.”
A crucial component of SAA’s overarching mission is a commitment to expanding the number of rheumatologists and researchers in the US who focus on spondyloarthritis.
To this end, we created the Spondylitis Association Bruckel Young Investigator Award, which recognizes outstanding “contributions to the care and understanding of patients with spondyloarthritis.” SAA awards the winner a $10,000 grant for use in spondyloarthritis research. In 2013, we were thrilled to present this annual award to Nigil Haroon, MD, PhD, DM.
It’s interesting to note that the researchers found a 10% decrease in mortality risk in patients with AS associated with use of nonsteroidal anti-inflammatory drugs (NSAIDs), and a 25% reduced risk associated with use of statins.
“The decrease in risk with NSAID use may come as a surprise to the readers. We generally consider NSAIDs to increase risk of vascular events”, said Dr. Haroon. “A previous study in RA also showed [a decrease in risk with NSAID use.] Hence, in inflammatory disease, anti-inflammatories may protect patients from vascular death. However, it should be borne in mind that this might be a reflection of NSAIDs being used in the elderly population with lowest risk of vascular events.”
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