Prevalence of Cardiovascular Disease in Patients with Ankylosing Spondylitis: An Analysis from a Nationwide Thailand Healthcare Database

Abstract

Abstract
Background: Chronic inflammation of Ankylosing spondylitis (AS) may be associated with cardiovascular disease (CVD). However, the association remains controversial.
Objectives: To determine whether patients with AS are at risk for CVD and the impact of atherosclerosis risk disease in AS.
Methods: We conducted a descriptive study based on a nationwide Thailand healthcare database, using ICD-10 of AS (M45). CVD was defined as either myocardial infarction (MI) (I20-I25), stroke (G45, I63, I69), peripheral arterial disease (I74), heart failure (HF) (I50), cardiomyopathy (I42), aortic valve disease (I35) or arrhythmia (I44). Atherosclerosis risk diseases were defined as either diabetes mellitus (DM) (E10, E11, E13), Hypertension (HT) (I10, I15), or dyslipidemia (DLD) (E78). A total of 766 hospitalized AS patients were included in the analysis. The odds ratio (OR) was calculated to define the risk of CVD and atherosclerosis risk disease.

Results: The mean age was 51 years, 74% were male. The respective highest prevalence of CVD and atherosclerosis risk disease was HF (2.9%) and HT (23%). Patients with HT, DM, or DLD were increased risk of stroke with OR 12.10 (95%CI 4.01-36.55), HT or DLD were increased risk of MI with OR 8.06 (95%CI 2.68-24.34), HT and DLD increased risk of aortic valve disease OR 6.37 (95%CI 1.63-24.88), HT increased risk of cardiac arrhythmias with OR 3.80 (95%CI 1.52-9.50), and DLD increased risk of HF with OR 3.68 (95%CI 1.31-10.36).
Conclusions: The prevalence of CVD is infrequently found in AS patients. The presence of atherosclerosis risk disease consistently increases the risk of CVD.