Association of Acute Myocardial Infarction with ankylosing Spondylitis: A nationwide longitudinal cohort study

Choi

2020

Int J of Rheum Dis

Aim Cardiovascular (CV) risk and mortality associated with spondyloarthritis (SpA) remain controversial. Herein, we performed a meta‐analysis of the latest large‐scale population‐based studies to demonstrate the elevated risk of CV disease and mortality in patients with SpA than in the general population. Methods MEDLINE and EMBASE databases were searched systematically for population‐based studies published between January 1997 and September 2019. Additional manual literature searches were also performed. All searches and data collection were performed independently by 2 reviewers. We calculated the risks of myocardial infarction (MI), stroke, and all‐cause mortality in a meta‐analysis and determined the risk ratios (RR) using the Mantel–Haenszel method. Results Among the 641 identified articles, 16 articles involving 18 cases met the inclusion criteria for our meta‐analysis; these included 12 cases of ankylosing spondylitis, five cases of psoriatic arthritis, and 1 case of undifferentiated SpA. Our meta‐analysis revealed a significantly high risk of MI (RR: 1.52; 95% CI: 1.29‐1.80) and stroke (RR: 1.21; 95% CI: 1.0‐1.47) in patients with SpA than in the general population. However, this increased risk was not significant in terms of all‐cause mortality (RR: 1.23; 95% CI: 0.96‐1.57). Conclusions Our meta‐analysis demonstrated that patients with SpA have a significantly increased risks of MI and stroke, but without a significant increase in the all‐cause mortality, than that in the general population. The higher risk of CV in patients with SpA than that in the general population indicates the need for strict risk factor correction and disease management.

Section: Discussionmentioning

confidence: 66%

Cardiovascular morbidity and mortality in patients with spondyloarthritis: A meta‐analysis

Choi

2020

Int J of Rheum Dis

Journal of Cardiovascular Emergencies

“…There are several points of interest in the two cases: (1) first-degree relatives with almost the same age at the on- The average prevalence rate of CAD in AS patients is about two-to three-fold higher in comparison with the general population. 1,2 Nonetheless, brother B developed an acute myocardial infarction even without this highly predisposing risk factor, at almost the same age as his brother, with an identical coronary artery involvement.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, patients with AS have an increased risk of developing metabolic syndrome and dyslipidemia. Also, a considerable increase in intima-mediathickness was found in AS, which is a marker of subclinical atherosclerosis 1,3. Besides the inflammatory effects of AS on the endothelium and the accelerated atherosclerotic process, the limited functional capacity due to chronic joint pain leads to sedentary lifestyle and weight gain, increasing cardiovascular risk and favoring the development and vulnerabilization of coronary atherosclerosis 6.…”

mentioning

confidence: 99%

Identical STEMI Pattern in Two Siblings with Different Risk Factors

Gerculy¹,

Libenciuc²,

Raț³

et al. 2020

Environmental factors may have an important role in the development of coronary heart disease. However, it is not clearly understood yet how the genetic factors interplay with the environmental ones in the onset of acute myocardial infarction. The early onset of coronary artery disease in cases with a positive family history suggests a certain role of genetic predisposition, but the open question remains: could environmental differences contribute to this predisposition? This case report describes similar coronary angiographic findings of two brothers who developed acute myocardial infarction in their early 40s, after being exposed to different environmental risk factors.

“…The remaining 3% represent the lower income class, who are in the Medical Aid program. The NHIS claim database includes extensive information about demographics, medical care and treatments, medical procedures, and various disease diagnoses according to the 10th revised codes of the International Classification of Diseases (ICD-10) [ 12 , 17 , 18 , 22 ]. The database is open to any researchers whose study protocols have been approved by an official review committee.…”

Section: Methodsmentioning

confidence: 99%

Change of Pyogenic and Tuberculous Spondylitis between 2007 and 2016 Year : A Nationwide Study

Hong

et al. 2020

J Korean Neurosurg Soc

Self Cite

Objective We attempted to compare the incidence of pyogenic spondylitis (PS) and tuberculous spondylitis (TS) between 2007 and 2016. Furthermore, we investigated the patients who underwent surgery in 2016 compared to that in 2007. Methods We used a nationwide database managed by the Korean National Health Insurance Service (NHIS) in 2007 and 2016. Total 9655 patients with a newly diagnosis of PS or TS were enrolled in PS or TS group. Among them, 1721 patients underwent either fusion or decompression surgery. We analyzed demographic distribution of patients according to gender and age and year of diagnosis. Results Comparing between 2007 and 2016, the incidence of PS has increased in 2016 than in 2007 (4874 vs. 2431, p <0.0001). Conversely, declination of incidence of TS was discovered in 2016 compared to 2007 (594 vs. 1756, p <0.0001). Females showed predominance over males regarding both PS and TS (5228 vs. 4427, p <0.0001). Among them, the number of PS patients who underwent surgery increased significantly in 2016 relative to that in 2007 (979 vs. 592, p <0.0001). Conclusion This nationwide study suggests that PS may increase and TS may decrease in Korea. In addition, demand for surgery regarding PS may increase.