Objectives: Patients with ankylosing spondylitis (AS) have a higher risk of cardiovascular events than controls. Although biological disease-modifying anti-rheumatic drugs (bDMARDs) are efficacious in treating AS, their effect on cardiovascular risk remains unclear. This study evaluated the effect of tumour necrosis factor inhibitors (TNFis) and interleukin-17 inhibitors (IL-17is) on cardiovascular risk in patients with AS.
Methods: Data of 43,502 patients diagnosed with AS from 2010 onwards and without prior history of cardiovascular events were extracted from the Korean nationwide database. Cardiovascular events were defined as incident myocardial infarctions or strokes. Patients were followed-up through 2021. The risk of cardiovascular events was compared between TNFis exposure (vs. bDMARDs non-exposure), IL-17is exposure (vs. bDMARDs non-exposure), and IL-17is exposure (vs. TNFis exposure), using time-dependent Cox models.
Results: The incidence rates of cardiovascular events during bDMARDs non-exposure, TNFis exposure, and IL-17is exposure were 18.66, 8.92, and 12.87 per 10,000 person-years, respectively. TNFis exposure (vs. bDMARDs non-exposure) was significantly associated with a lower risk of cardiovascular events (adjusted hazard ratio [aHR] = 0.697, 95% confidence interval [CI] = 0.499-0.973), whereas IL-17is exposure (vs. bDMARDs non-exposure) was not (aHR = 0.962, 95% CI = 0.134-6.920). The risk of cardiovascular events did not differ between IL-17is and TNFis exposures (aHR = 1.381, 95% CI = 0.189-10.087).
Conclusions: TNFis exposure (vs. bDMARDs non-exposure) was associated with approximately 30% lower risk of cardiovascular events in patients with AS. IL-17is exposure had no significant association with the risk of cardiovascular events compared with bDMARDs non-exposure or TNFis exposure. Key Points • TNFis exposure was associated with a 30% lower cardiovascular risk in patients with AS. • IL-17is exposure had no significant association with cardiovascular risk in patients with AS. • TNFis could be the preferred bDMARD with regard to cardiovascular risk in patients with AS.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10067-024-07225-7 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prognostic value of left atrioventricular coupling index in heart failure.
Eur Heart J Cardiovasc Imaging
January 2025
Heart Institute, Department of Cardiology. Germans Trias i Pujol University Hospital, Barcelona,Spain.
Aims: To investigate the distribution of left atrioventricular coupling index (LACI) among patients with heart failure and left ventricular ejection fraction (LVEF)<50% and to explore its association with the combined endpoint of all-cause death or HF hospitalization at long term follow-up.
Methods And Results: Patients with HF and LVEF<50% undergoing cardiac magnetic resonance (CMR) were evaluated. Patients with atrial fibrillation or flutter were excluded.
Unsupervised clustering of intraventricular hemodynamic forces for the phenotyping of left-ventricular function in non-ischemic left ventricular cardiomyopathy.
Eur Heart J Cardiovasc Imaging
January 2025
Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.
Background: Cardiac magnetic resonance (CMR) is essential for diagnosing cardiomyopathy, serving as the gold standard for assessing heart chamber volumes and tissue characterization. Hemodynamic forces (HDF) analysis, a novel approach using standard cine CMR images, estimates energy exchange between the left ventricular (LV) wall and blood. While prior research has focused on peak or mean longitudinal HDF values, this study aims to investigate whether unsupervised clustering of HDF curves can identify clinically significant patterns and stratify cardiovascular risk in non-ischemic LV cardiomyopathy (NILVC).
View Article and Find Full Text PDFComparative analysis of general and regional anesthesia applications in geriatric hip fracture surgery.
Medicine (Baltimore)
January 2025
Department of Anesthesiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Background: This study compares the outcomes of general anesthesia (GA) and regional anesthesia (RA) in geriatric hip fracture surgery to determine optimal anesthesia strategies for this population.
Methods: A comprehensive literature review was conducted, analyzing studies comparing GA and RA in elderly patients undergoing hip fracture surgery. Studies encompassed various designs, including randomized controlled trials, cohort studies, and meta-analyses.
Temporal trends of transcatheter aortic valve replacement outcomes in a high-volume center from China.
J Chin Med Assoc
November 2024
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Since the first transcatheter aortic valve replacement (TAVR) was performed in China in 2010, TAVR has developed rapidly. However, the temporal trends in the 1-year prognosis after TAVR in China have not been described. This study enrolled patients treated at a high-volume Chinese TAVR center, West China Hospital, between 2015 and 2022, to analyze and characterize the temporal trends in 1-year outcomes.
View Article and Find Full Text PDFRisk of Major Adverse Cardiovascular Events in Home Dialysis Compared With In-Center Hemodialysis.
Clin J Am Soc Nephrol
January 2025
Nephrology Department, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!