Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study
BackgroundUveitis, a sight-threatening ocular inflammatory state, is associated with autoimmune diseases and systemic inflammation. This prolonged systemic inflammation may cause plaque formation in coronary arteries, subsequently resulting in acute coronary syndrome (ACS).MethodsThis retrospective,...
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.890543/full |
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| author | Kathy Ming Feng Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Yi-Hao Chen Chien-An Sun Chien-An Sun Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Jiann-Torng Chen Ching-Long Chen |
| author_facet | Kathy Ming Feng Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Yi-Hao Chen Chien-An Sun Chien-An Sun Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Jiann-Torng Chen Ching-Long Chen |
| author_sort | Kathy Ming Feng |
| collection | DOAJ |
| description | BackgroundUveitis, a sight-threatening ocular inflammatory state, is associated with autoimmune diseases and systemic inflammation. This prolonged systemic inflammation may cause plaque formation in coronary arteries, subsequently resulting in acute coronary syndrome (ACS).MethodsThis retrospective, population-based study (15-year period) used the Longitudinal Health Insurance Database based on the National Health Insurance Research Database in Taiwan. Chi-square and Student’s t-tests were used to examine differences between the study and comparison cohorts for categorical and continuous variables, respectively. Fine and Gray’s competing risk model was used to determine the hazard ratio of the risk of ACS. Furthermore, the cumulative risk of ACS was determined using Kaplan-Meier analysis.ResultsA total of 1,111 patients with AS and uveitis were enrolled in this study cohort, and 4,444 patients with AS without uveitis were enrolled in the comparison cohort. After adjustment for age, sex, and comorbidities, patients with AS and uveitis demonstrated an increased risk of ACS compared to those without uveitis (adjusted hazard ratio: 1.675, p<0.001). In addition, Kaplan-Meier analysis revealed that patients with AS and uveitis had a significantly higher risk of ACS than those without uveitis (p<0.001). Age, diabetes mellitus, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, asthma, and systemic steroids were significant risk factors for ACS. Both anterior uveitis and posterior segment involvement were associated with an increased risk of ACS in patients with AS. All-cause mortality was higher in the uveitis group (9.81%) than in the non-uveitis group (8.10%) (p=0.015).ConclusionOur analysis revealed that uveitis could potentially be a predictor of ACS in patients with AS. However, further prospective controlled studies are required to assess the association between uveitis and ACS in patients with AS. |
| first_indexed | 2024-12-11T18:34:31Z |
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| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-11T18:34:31Z |
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| spelling | doaj.art-681bf389a18947afa75e2430d99c00b72022-12-22T00:54:49ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-06-011310.3389/fimmu.2022.890543890543Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort StudyKathy Ming Feng0Wu-Chien Chien1Wu-Chien Chien2Wu-Chien Chien3Wu-Chien Chien4Yi-Hao Chen5Chien-An Sun6Chien-An Sun7Chi-Hsiang Chung8Chi-Hsiang Chung9Chi-Hsiang Chung10Jiann-Torng Chen11Ching-Long Chen12Department 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, TaiwanTaiwanese Injury Prevention and Safety Promotion Association, Taipei, TaiwanGraduate Institute of Life Sciences, National Defense Medical Center, Taipei, TaiwanDepartment of Ophthalmology, Tri-Service General Hospital, 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, TaiwanBackgroundUveitis, a sight-threatening ocular inflammatory state, is associated with autoimmune diseases and systemic inflammation. This prolonged systemic inflammation may cause plaque formation in coronary arteries, subsequently resulting in acute coronary syndrome (ACS).MethodsThis retrospective, population-based study (15-year period) used the Longitudinal Health Insurance Database based on the National Health Insurance Research Database in Taiwan. Chi-square and Student’s t-tests were used to examine differences between the study and comparison cohorts for categorical and continuous variables, respectively. Fine and Gray’s competing risk model was used to determine the hazard ratio of the risk of ACS. Furthermore, the cumulative risk of ACS was determined using Kaplan-Meier analysis.ResultsA total of 1,111 patients with AS and uveitis were enrolled in this study cohort, and 4,444 patients with AS without uveitis were enrolled in the comparison cohort. After adjustment for age, sex, and comorbidities, patients with AS and uveitis demonstrated an increased risk of ACS compared to those without uveitis (adjusted hazard ratio: 1.675, p<0.001). In addition, Kaplan-Meier analysis revealed that patients with AS and uveitis had a significantly higher risk of ACS than those without uveitis (p<0.001). Age, diabetes mellitus, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, asthma, and systemic steroids were significant risk factors for ACS. Both anterior uveitis and posterior segment involvement were associated with an increased risk of ACS in patients with AS. All-cause mortality was higher in the uveitis group (9.81%) than in the non-uveitis group (8.10%) (p=0.015).ConclusionOur analysis revealed that uveitis could potentially be a predictor of ACS in patients with AS. However, further prospective controlled studies are required to assess the association between uveitis and ACS in patients with AS.https://www.frontiersin.org/articles/10.3389/fimmu.2022.890543/fullacute coronary syndromeankylosing spondylitisuveitiscardiovascular diseaseepidemiology |
| spellingShingle | Kathy Ming Feng Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Yi-Hao Chen Chien-An Sun Chien-An Sun Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Jiann-Torng Chen Ching-Long Chen Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study Frontiers in Immunology acute coronary syndrome ankylosing spondylitis uveitis cardiovascular disease epidemiology |
| title | Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study |
| title_full | Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study |
| title_fullStr | Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study |
| title_full_unstemmed | Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study |
| title_short | Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study |
| title_sort | increased risk of acute coronary syndrome in ankylosing spondylitis patients with uveitis a population based cohort study |
| topic | acute coronary syndrome ankylosing spondylitis uveitis cardiovascular disease epidemiology |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.890543/full |
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