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Open Access 01-04-2021 | Myocardial Infarction | Original Article

Characteristics and outcome of a first acute myocardial infarction in patients with ankylosing spondylitis

Authors: Anna Södergren, Johan Askling, Karin Bengtsson, Helena Forsblad-d’Elia, Tomas Jernberg, Ulf Lindström, Lotta Ljung, Ängla Mantel, Lennart T. H. Jacobsson

Published in: Clinical Rheumatology | Issue 4/2021

Abstract

Objectives

To study clinical characteristics, mortality, and secondary prevention, after a first incident acute myocardial infarction (AMI) in patients with ankylosing spondylitis (AS) compared with the general population.

Methods

In total, 292 subjects with AS and a first AMI between Jan 2006 and Dec 2014 were identified using the Swedish national patient register. Each subject was matched with up to 5 general population comparators per AS-patient (n = 1276). Follow-up started at the date of admission for AMI and extended until death or 365 days of follow-up. Cox regression was used to assess mortality in two time intervals: days 0–30 and days 31–365. For a subgroup with available data, clinical presentation at admission, course, treatment for AMI, and secondary prevention were compared.

Results

During the 365-day follow-up, 56/292 (19%) AS patients and 184/1276 (14%) comparators died. There were no difference in mortality due to cardiovascular-related causes, although the overall mortality day 31–365 was increased among patients with AS compared with comparators (HR [95% CI] = 2.0 [1.3;3.0]). At admission, AS patients had a higher prevalence of cardiovascular comorbidities compared with comparators. At discharge, patients with AS were less often prescribed lipid-lowering drugs and non-aspirin antiplatelet therapy.

Conclusions

Patients with AS tend to have a higher comorbidity burden at admission for first AMI. The mortality after a first AMI due to cardiovascular-related causes does not seem to be elevated, despite an increased overall mortality during days 31–365 among patients with AS compared with the general population.

Key Points

• The all-cause mortality after a first AMI was higher in patients with AS.

• Mortality after a first AMI due to CVD-related causes does not seem to be elevated for patients with AS.

• In patients with AS suffering a first AMI, more attention should be given to other comorbidities causing an excess in mortality.

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Title: Characteristics and outcome of a first acute myocardial infarction in patients with ankylosing spondylitis
Authors: Anna Södergren
Johan Askling
Karin Bengtsson
Helena Forsblad-d’Elia
Tomas Jernberg
Ulf Lindström
Lotta Ljung
Ängla Mantel
Lennart T. H. Jacobsson
Publication date: 01-04-2021
Publisher: Springer International Publishing
Keywords: Myocardial Infarction
Ankylosing Spondylitis
Published in: Clinical Rheumatology / Issue 4/2021
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-020-05354-3

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