Risk of venous thromboembolism in ankylosing spondylitis: a general population-based study

Abstract

BackgroundVenous thromboembolism (VTE), including pulmonary embolism (PE) and deep venous thrombosis (DVT), can be life threatening. An increased frequency of VTE has been found in inflammatory conditions. To date, evidence assessing whether this risk is also greater in patients with ankylosing spondylitis (AS) is scarce.MethodsUsing the provincial British Columbia, Canada healthcare database that encompasses all residents within the province, we conducted matched cohort analyses of incident PE, DVT and overall VTE among incident cases of AS and compared them with individuals randomly selected from the general population without AS. We calculated incidence rates (IRs) of VTE and multivariable analyses after adjusting for traditional risk factors using Cox models.ResultsAmong 7190 incident cases of AS, 35 developed PE and 47 developed DVT. IRs of PE, DVT and overall VTE per 1000 person-years for patients with AS were 0.79, 1.06, 1.56 compared with 0.40, 0.50, 0.77 in the control cohort. Corresponding fully adjusted HRs (95% CI) of PE, DVT and VTE were 1.36 (0.92 to 1.99), 1.62 (1.16 to 2.26) and 1.53 (1.16 to 2.01), respectively. The risks of PE, DVT and VTE were highest in the first year of diagnosis with HR (95% CI) of 2.88 (0.87 to 9.62), 2.20 (0.80 to 6.03) and 2.10 (0.88 to 4.99), respectively.ConclusionsThese findings demonstrate an increased risk of VTE in the general AS population. This risk appears the most prominent in the first year after diagnosis.

The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis

“…AS is also a young-onset disease, with initial symptoms occuring before the age of 40 in about 90% of patients [7]. Along with its physical impacts on patients' pain and disability [8][9][10], studies have also shown the association of AS with physical complications including various cardiovascular diseases [11,12].…”

Circulating Retinol-Binding Protein 4 as a Possible Biomarker of Treatment Response for Ankylosing Spondylitis: An Array-Based Comparative Study

“…(Brouwer et al, 2004;Gobel et al, 2018), were also AS-related. Recently, a large population-based cohort study disclosed AS was associated with a higher risk of venous thromboembolism (VTE) compared with people without AS (Avina-Zubieta et al, 2019). Herein, our results suggest that an abnormal coagulation status exists in AS and may contribute to the increased VTE risk.…”

Association between ankylosing spondylitis and venous thromboembolism

“…Some of my views are shared with the readers as follows. First, the overall incidence of venous thromboembolism was 2.03-fold higher in people with ankylosing spondylitis than in those people without ankylosing spondylitis in Aviña-Zubieta et al ’s study (1.56 vs 0.77 per 1000 person-years) 3. The attributable risk associated with ankylosing spondylitis was 0.79 per 1000 person-years; that is, removal of ankylosing spondylitis can diminish approximately eight cases of venous thromboembolism per 10 000 person-years of follow-up.…”

“…The relationship between ankylosing spondylitis and other diseases has been extensively explored 1 2. Recently, a cohort study in Canada conducted by Aviña-Zubieta et al published in Annals of Rheumatic Diseases disclosed that people with ankylosing spondylitis were at higher risk of venous thromboembolism compared with people without ankylosing spondylitis (HR 1.53, 95% CI 1.16 to 2.01) 3. Aviña-Zubieta et al ’s study is well performed and is informative to the researchers.…”