Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort Study
BackgroundAnkylosing spondylitis (AS) is a chronic inflammatory disease. Excess cardiovascular risks were well recognized in patients with AS and were attributed to prolonged systemic inflammation. Uveitis is one of the most common extra-articular symptoms of AS and is also considered an indicator o...
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2021.811664/full |
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| author | Yi-Fen Lai Ting-Yi Lin Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Chien-An Sun Chien-An Sun Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Yi-Hao Chen Jiann-Torng Chen Ching-Long Chen |
| author_facet | Yi-Fen Lai Ting-Yi Lin Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Chien-An Sun Chien-An Sun Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Yi-Hao Chen Jiann-Torng Chen Ching-Long Chen |
| author_sort | Yi-Fen Lai |
| collection | DOAJ |
| description | BackgroundAnkylosing spondylitis (AS) is a chronic inflammatory disease. Excess cardiovascular risks were well recognized in patients with AS and were attributed to prolonged systemic inflammation. Uveitis is one of the most common extra-articular symptoms of AS and is also considered an indicator of systemic inflammation. This study aimed to investigate whether uveitis was a risk factor for developing acute myocardial infarction (AMI) in patients with AS using the National Health Insurance Research Database (NHIRD).MethodsData were collected from the NHIRD over a fifteen-year period. Variables were analyzed using the Pearson chi-square test and Fisher’s exact test. Risk factors for the occurrence of AMI were examined by calculating hazard ratio. Kaplan-Meier analysis was performed to compare the cumulative incidence of AMI in the uveitis and non-uveitis cohorts.ResultsA total of 5905 patients with AS were enrolled, including 1181 patients with uveitis (20%) and 4724 patients without uveitis (80%). The Kaplan–Meier method with the log-rank test showed that the uveitis group had a significantly higher cumulative hazard for patients with AMI than the non-uveitis group (p < 0.001). The adjusted hazard ratio (aHR) of AMI was higher in the uveitis group than in the non-uveitis group (aHR = 1.653, p < 0.001). Stratified analysis revealed that patients with uveitis had an increased risk of developing AMI regardless of their sex (male/female aHR = 1.688/1.608, p < 0.001). Patients with uveitis in all age groups were independently associated with an increased risk of developing AMI compared to those without uveitis (20–39 years/40–59 years/≥ 60 years, aHR = 1.550, 1.579, 3.240, p < 0.001). Patients with uveitis had a higher probability of developing AMI regardless of comorbidities. Uveitis patients with comorbidities had a higher risk of developing AMI compared to uveitis patients without comorbidities.ConclusionUveitis is a significant risk factor for developing AMI in patients with AS. Physicians should be aware of the potential cardiovascular risk in AS patients with uveitis, especially simultaneously with other traditional risk factors of AMI. Further prospective studies are needed to elucidate the underlying mechanism between uveitis and AMI in patients with AS. |
| first_indexed | 2024-04-11T21:04:49Z |
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| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-11T21:04:49Z |
| publishDate | 2022-01-01 |
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| series | Frontiers in Immunology |
| spelling | doaj.art-59916cb5e50f49e19b7a3e26b2cc8f5c2022-12-22T04:03:23ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-01-011210.3389/fimmu.2021.811664811664Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort StudyYi-Fen Lai0Ting-Yi Lin1Wu-Chien Chien2Wu-Chien Chien3Wu-Chien Chien4Chien-An Sun5Chien-An Sun6Chi-Hsiang Chung7Chi-Hsiang Chung8Chi-Hsiang Chung9Yi-Hao Chen10Jiann-Torng Chen11Ching-Long Chen12Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanSchool of Public Health, National Defense Medical Center, Taipei, TaiwanGraduate of Life Sciences, National Defense Medical Center, Taipei, TaiwanDepartment of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, TaiwanBig Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, TaiwanDepartment of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanSchool of Public Health, National Defense Medical Center, Taipei, TaiwanTaiwanese Injury Prevention and Safety Promotion Association, Taipei, TaiwanDepartment of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanBackgroundAnkylosing spondylitis (AS) is a chronic inflammatory disease. Excess cardiovascular risks were well recognized in patients with AS and were attributed to prolonged systemic inflammation. Uveitis is one of the most common extra-articular symptoms of AS and is also considered an indicator of systemic inflammation. This study aimed to investigate whether uveitis was a risk factor for developing acute myocardial infarction (AMI) in patients with AS using the National Health Insurance Research Database (NHIRD).MethodsData were collected from the NHIRD over a fifteen-year period. Variables were analyzed using the Pearson chi-square test and Fisher’s exact test. Risk factors for the occurrence of AMI were examined by calculating hazard ratio. Kaplan-Meier analysis was performed to compare the cumulative incidence of AMI in the uveitis and non-uveitis cohorts.ResultsA total of 5905 patients with AS were enrolled, including 1181 patients with uveitis (20%) and 4724 patients without uveitis (80%). The Kaplan–Meier method with the log-rank test showed that the uveitis group had a significantly higher cumulative hazard for patients with AMI than the non-uveitis group (p < 0.001). The adjusted hazard ratio (aHR) of AMI was higher in the uveitis group than in the non-uveitis group (aHR = 1.653, p < 0.001). Stratified analysis revealed that patients with uveitis had an increased risk of developing AMI regardless of their sex (male/female aHR = 1.688/1.608, p < 0.001). Patients with uveitis in all age groups were independently associated with an increased risk of developing AMI compared to those without uveitis (20–39 years/40–59 years/≥ 60 years, aHR = 1.550, 1.579, 3.240, p < 0.001). Patients with uveitis had a higher probability of developing AMI regardless of comorbidities. Uveitis patients with comorbidities had a higher risk of developing AMI compared to uveitis patients without comorbidities.ConclusionUveitis is a significant risk factor for developing AMI in patients with AS. Physicians should be aware of the potential cardiovascular risk in AS patients with uveitis, especially simultaneously with other traditional risk factors of AMI. Further prospective studies are needed to elucidate the underlying mechanism between uveitis and AMI in patients with AS.https://www.frontiersin.org/articles/10.3389/fimmu.2021.811664/fulluveitisacute myocardial infarctionankylosing spondylitiscardiovascular diseaseepidemiology |
| spellingShingle | Yi-Fen Lai Ting-Yi Lin Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Chien-An Sun Chien-An Sun Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Yi-Hao Chen Jiann-Torng Chen Ching-Long Chen Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort Study Frontiers in Immunology uveitis acute myocardial infarction ankylosing spondylitis cardiovascular disease epidemiology |
| title | Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort Study |
| title_full | Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort Study |
| title_fullStr | Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort Study |
| title_full_unstemmed | Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort Study |
| title_short | Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort Study |
| title_sort | uveitis as a risk factor for developing acute myocardial infarction in ankylosing spondylitis a national population based longitudinal cohort study |
| topic | uveitis acute myocardial infarction ankylosing spondylitis cardiovascular disease epidemiology |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2021.811664/full |
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