title: No increased rate of acute myocardial infarction or stroke among patients with ankylosing spondylitis-a retrospective cohort study using routine data.
abstract: OBJECTIVE
  To examine if people with ankylosing spondylitis (AS) are at higher risk of acute myocardial infarction (MI) or stroke compared to those without AS.
  
  
  METHODS
  Primary care records were linked with all hospital admissions and deaths caused by MI or stroke in Wales for the years 1999-2010. The linked data were then stratified by AS diagnosis and survival analysis was used to obtain the incidence rate of MI and separately cerebrovascular disease (CVD)/stroke. Cox regression was used to adjust for gender and age. Logistic regression was used to examine prevalence of diabetes, hypertension, or hyperlipidemia for those with AS compared to those without.
  
  
  RESULTS
  There were 1686 AS patients (75.9% male, average age 46.1 years) compared to 1,206,621 controls (48.9% male, average age 35.9 years). Age- and gender-adjusted hazard ratios for MI were 1.28 (95% CI: 0.93 to 1.74) P = 0.12, and for CVD/stroke 1.0 (95% CI: 0.73 to 1.39) P = 0.9, in AS compared to controls. The prevalence of diabetes and hypertension, but not hyperlipidemia/hypercholesterolemia, was higher in AS.
  
  
  CONCLUSIONS
  There is no increase in the MI or CVD/stroke rates in patients with AS compared to those without AS, despite higher rates of hypertension, which may be related to nonsteroidal anti-inflammatory drug use.
authors.affiliation: Swansea University, Wales, UK. Electron. s.brophy@swansea.ac.uk
authors.forename: Sinead
authors.initials: S
authors.lastname: Brophy
authors.forename: Roxanne
authors.initials: R
authors.lastname: Cooksey
authors.forename: Mark
authors.initials: M
authors.lastname: Atkinson
authors.forename: Shang-Ming
authors.initials: SM
authors.lastname: Zhou
authors.forename: Muhammad Jami
authors.initials: MJ
authors.lastname: Husain
authors.forename: Steven
authors.initials: S
authors.lastname: Macey
authors.forename: Muhammad Azizur
authors.initials: MA
authors.lastname: Rahman
authors.forename: Stefan
authors.initials: S
authors.lastname: Siebert
mesh_terms: D000328:Adult; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000453:epidemiology*; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D015996:Survival Rate; D014852:Wales / Q000453:epidemiology