A national population-based longitudinal cohort study was conducted in Taiwan, using 2000 to 2015 data from the National Health Insurance Research Database, to evaluate the incidence of acute myocardial infarction (AMI) in patients with ankylosing spondylitis with or without comorbid uveitis.
Study design
A total of 5905 patients included in the cohort had 3 outpatient visits or a single inpatient claim for a diagnosis of ankylosing spondylitis; 20% also had uveitis. Patients were then followed until an AMI occurred or until the end of the study period.
Outcomes
At the end of the follow-up period (mean 9.9 years), 11.7% of patients in the uveitis group and 8.8% of patients in the non-uveitis group experienced an AMI, a statistically significant difference. The overall incidence rate was 1306.5 per 100,000 person-years and 885.5 per 100,000 person-years, respectively. Risk factors for developing an AMI included diabetes and metabolic syndrome, hyperlipidemia, hypertension, and cardiovascular disease, but age and gender were not factors.
Limitations
This was a retrospective study, and no laboratory data or data on diet, smoking, and physical activity were included in the database. The severity of ankylosing spondylitis, as determined with MRI, was not known. No assessment of the influence of uveitis treatments on development of AMI was conducted. Finally, the study population was ethnically homogenous.
Clinical significance
In patients with ankylosing spondylitis, comorbid uveitis was associated with an increased risk of having an AMI. Physicians should closely monitor the cardiovascular system in these patients, for early detection of AMI and optimal treatment.