TY - JOUR
T1 - Ankylosing spondylitis is associated with increased prevalence of valvular heart diseases
T2 - a cross-sectional population-based study
AU - Eid, Siwar
AU - Sharif, Kassem
AU - McGonagle, Dennis
AU - Patt, Yonatan Shneor
AU - Tsur, Avishai M.
AU - Adawi, Mohammad
AU - Cohen, Arnon D.
AU - Amital, Howard
AU - Watad, Abdulla
N1 - Publisher Copyright:
© 2023 Oxford University Press. All rights reserved.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Background: Ankylosing spondylitis (AS) is a chronic inf lammatory arthritis primarily affecting the sacroiliac joint and axial skeleton with associated extra-articular involvement including cardiovascular system disease including aortic valve disease with variable reported prevalence. The aim of this study is to determine the prevalence of heart valve disorders in AS patients. Methods: This was a retrospective, population-based, cross-sectional study that retrieved data from the Clalit Health Services registry. Cases were defined as having AS, whereas controls were frequency matched by age and sex in a ratio of 5:1. The prevalence of valvular heart diseases was compared between the two groups; a multivariate logistic regression model was applied to estimate the association after controlling for potential confounders. Results: We included 4082 AS patients and 20 397 controls frequency matched by age and sex. AS patients had a significantly higher prevalence of cardiovascular risk factors (P < .001) and a higher prevalence of valvular heart disease. In the multivariate logistic regression model, adjusting for multiple confounding factors, AS was independently associated with aortic stenosis [odds ratio (OR): 2.25, 95% confidence interval (CI): 1.57–3.23, P < 0.001], aortic insufficiency (OR: 2.44, 95% CI: 1.50–3.94, P < 0.001), and mitral insufficiency (OR: 1.75, 95% CI: 1.17–2.61, P < 0.001) but not mitral stenosis (OR: 1.31, 95% CI: 0.60–2.70, P = 0.47). Conclusions: Our study reports the increased risk of valvular heart diseases in patients with AS, possibly due to the inf lammatory milieu associated with the disease process and the result of biomechanical stress affecting the enthesis-like valvular structures.
AB - Background: Ankylosing spondylitis (AS) is a chronic inf lammatory arthritis primarily affecting the sacroiliac joint and axial skeleton with associated extra-articular involvement including cardiovascular system disease including aortic valve disease with variable reported prevalence. The aim of this study is to determine the prevalence of heart valve disorders in AS patients. Methods: This was a retrospective, population-based, cross-sectional study that retrieved data from the Clalit Health Services registry. Cases were defined as having AS, whereas controls were frequency matched by age and sex in a ratio of 5:1. The prevalence of valvular heart diseases was compared between the two groups; a multivariate logistic regression model was applied to estimate the association after controlling for potential confounders. Results: We included 4082 AS patients and 20 397 controls frequency matched by age and sex. AS patients had a significantly higher prevalence of cardiovascular risk factors (P < .001) and a higher prevalence of valvular heart disease. In the multivariate logistic regression model, adjusting for multiple confounding factors, AS was independently associated with aortic stenosis [odds ratio (OR): 2.25, 95% confidence interval (CI): 1.57–3.23, P < 0.001], aortic insufficiency (OR: 2.44, 95% CI: 1.50–3.94, P < 0.001), and mitral insufficiency (OR: 1.75, 95% CI: 1.17–2.61, P < 0.001) but not mitral stenosis (OR: 1.31, 95% CI: 0.60–2.70, P = 0.47). Conclusions: Our study reports the increased risk of valvular heart diseases in patients with AS, possibly due to the inf lammatory milieu associated with the disease process and the result of biomechanical stress affecting the enthesis-like valvular structures.
KW - ankylosing spondylitis
KW - aortic insufficiency
KW - epidemiology
KW - valvular heart diseases
UR - http://www.scopus.com/inward/record.url?scp=85172423736&partnerID=8YFLogxK
U2 - 10.1093/postmj/qgad045
DO - 10.1093/postmj/qgad045
M3 - Article
C2 - 37302111
AN - SCOPUS:85172423736
SN - 0032-5473
VL - 99
SP - 1088
EP - 1093
JO - Postgraduate Medical Journal
JF - Postgraduate Medical Journal
IS - 1176
ER -