Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study

Feng, Kathy Ming; Chien, Wu-Chien; Chen, Yi-Hao; Sun, Chien‐An; Chung, Chi‐Hsiang; Chen, Jiann‐Torng; Chen, Ching‐Long

doi:10.3389/fimmu.2022.890543

Cited by 8 publications

(8 citation statements)

References 47 publications

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“…To identify the potential origin of heterogeneity, leave-one-out sensitivity analysis was conducted. Of these three cohort studies, Bai et al [ 27 ], included AS patients with a history of AAU, whereas the other two studies (Feng et al [ 28 ], and Lai et al [ 29 ]) included AS patients with current combined uveitis. However, excluding Bai et al [ 27 ]., did not change the significant difference, but reduced the individual heterogeneity (HR = 1.66, 95% CI = 1.52–1.82, p < 0.00001; I 2 = 0%, p = 0.89) ( Figure S1 ), suggesting that significant heterogeneity was caused by the differences in recency of uveitis.…”

Section: Resultsmentioning

confidence: 99%

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Association Between Atherosclerosis-Related Cardiovascular Disease and Uveitis: A Systematic Review and Meta-Analysis

Gao

et al. 2022

Diagnostics

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Background: Uveitis is not only an intraocular inflammatory disease, but also an indicator of systemic inflammation. It is unclear whether uveitis can increase the risk of cardiovascular disease (CVD) through the atherosclerotic pathway. Methods: PubMed and Embase databases were searched until 5 September, 2022. Original studies investigating uveitis and cardiovascular events were selected. The random-effects model was used to calculate the difference of groups in pooled estimates. Results: A total of six observational studies that included mainly ankylosing spondylitis (AS) patients were included. Of these, three studies reported data on carotid plaques and carotid intima-media thickness (cIMT) and the other three studies provided data on atherosclerosis-related CVD. No significant difference was found in cIMT between uveitis and controls (MD = 0.01, 95% CI = −0.03–0.04, p = 0.66), consistent with the findings of carotid plaque incidence (OR = 1.30, 95% CI = 0.71–2.41, p = 0.39). However, uveitis was associated with a 1.49-fold increase in atherosclerosis-related CVD (HR = 1.49, 95% CI = 1.20–1.84, p = 0.0002). Conclusions: Uveitis is a predictor of atherosclerosis-related CVD in AS patients. For autoimmune disease patients with uveitis, earlier screening of cardiovascular risk factors and the implementation of corresponding prevention strategies may be associated with a better prognosis.

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Section: Resultsmentioning

confidence: 99%

“… ( A ) Forest plots showing pooled HR with 95% CI of atherosclerosis-related CVD for patients with uveitis versus those without. ( B ) Forest plots showing subgroup uveitis and atherosclerosis-related CVD [ 27 , 28 , 29 ]. …”

Section: Figurementioning

confidence: 99%

Association Between Atherosclerosis-Related Cardiovascular Disease and Uveitis: A Systematic Review and Meta-Analysis

Gao

et al. 2022

Diagnostics

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“…It is generally believed that SpA patients present with an atherogenic metabolic profile, with chronic systemic inflammation potentially exacerbating both past and future CV events. Notably, indicators of systemic inflammation such as uveitis or elevated CRP levels have been linked to increased CVD in ankylosing spondylitis patients [ 8 , 37 , 38 ]. In that way, these patients might see atherosclerotic events more frequently [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional analysis of cardiovascular disease and risk factors in patients with spondyloarthritis: a real-life evidence from biostar nationwide registry

Duruöz,

Bodur,

Ataman

et al. 2024

Rheumatol Int

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The association between spondyloarthritis and cardiovascular (CV) diseases is complex with variable outcomes. This study aimed to assess the prevalence rates of CV diseases and to analyze the impact of CV risk factors on CV disease in patients with spondyloarthritis. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group’s prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461–6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631–7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189–28.810, p = 0.030) were the independent predictors for CV disease. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group’s prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461–6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631–7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189–28.810, p = 0.030) were the independent predictors for CV disease. The prevalence rate of CV disease was 3.0% in patients with spondyloarthritis. Hypertension, dyslipidemia, and cancer history were the independent CV risk factors for CV disease in patients with spondyloarthritis.

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“…In addition, the levels of plasma cytokines like interleukin and C-reactive protein were higher in patients who were diagnosed with CHD [ 30 ]. In addition, certain systemic inflammatory diseases such as inflammatory bowel disease and ankylosing spondylitis are associated with the formation of CHD [ 31 , 32 ]. In addition to inflammation, hyperlipidemia is another mechanism of CHD which can contribute to the formation of atherosclerotic plaque as well as coronary arterial stenosis [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

The Extents of Coronary Heart Disease and the Severity of Newly Developed Dry Eye Disease: A Nationwide Cohort Study

Lee,

Yang,

Huang

et al. 2024

Diagnostics

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This study aimed to evaluate the potential association between coronary heart disease (CHD) severity and the subsequent dry eye disease (DED) with a different severity through the use of the National Health Insurance Research Database (NHIRD) of Taiwan. A retrospective cohort study was conducted. The CHD population was further divided into a severe CHD that had received coronary artery bypass graft (CABG) surgery group and a mild CHD that had received medicine group, then matched with a 1:2 ratio, and 29,852 and 14,926 CHD patients were put into the severe CHD and mild CHD groups, respectively. The primary outcomes were the development of DED and severe DED after CHD diagnosis. The Cox proportional hazards regression was used to produce the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of DED and severe DED between groups. There were 3440 and 1276 DED cases in the mild CHD and severe CHD groups, respectively. And another 37 and 48 severe CHD events were observed in the mild and severe CHD groups, respectively. The incidence of severe DED in the severe CHD group was significantly higher compared to the mild CHD group (aHR: 5.454, 95% CI: 1.551–7.180, p = 0.0001). The cumulative probabilities of DED and severe DED were significantly higher in the severe CHD group than the mild CHD group (both p < 0.0001). In the subgroup analysis, the correlation between severe CHD and DED was higher in the patients aged older than 70 years (p < 0.0001). In conclusion, severe CHD is associated with a higher incidence of severe DED with a higher cumulative incidence.

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Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study

Cited by 8 publications

References 47 publications

Association Between Atherosclerosis-Related Cardiovascular Disease and Uveitis: A Systematic Review and Meta-Analysis

Association Between Atherosclerosis-Related Cardiovascular Disease and Uveitis: A Systematic Review and Meta-Analysis

Cross-sectional analysis of cardiovascular disease and risk factors in patients with spondyloarthritis: a real-life evidence from biostar nationwide registry

The Extents of Coronary Heart Disease and the Severity of Newly Developed Dry Eye Disease: A Nationwide Cohort Study

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