High risk of cardiovascular diseases after diagnosis of multiple sclerosis.
BACKGROUND
Studies of the risk of cardiovascular diseases (CVDs) in patients with multiple sclerosis (MS) have the potential to improve our understanding of the etiology of and the heterogeneity of prognosis and outcomes.


OBJECTIVE
To investigate the risk of myocardial infarction (MI), stroke, heart failure (HF), and atrial fibrillation (AF) or Flutter in MS patients with different ethnicity, both female and male.


METHODS
Using Poisson regression, we performed a nationwide study in Sweden to investigate the association between the diagnosis of MS and the risk of MI, stroke, HF, or AF/Flutter in 8281 patients who were hospitalized due to MS from 1987 through 2009, plus 76,640 matched control individuals. We performed stratified analyses by sex, age at follow-up and country of birth.


RESULTS
Among MS patients, the incidence rate ratio for MI was 1.85 (95% confidence interval (CI) 1.59 to 2.15), for stroke was 1.71 (95% CI 1.46 to 2.00), for HF was 1.97 (95% CI 1.52 to 2.56) and for AF/Flutter was 0.63 (95% CI 0.46 to 0.87), as compared with individuals without MS. The increased risks were particularly prominent for women. These associations remained after stratification by sex, age and country of birth.


CONCLUSIONS
We recommend careful surveillance and preventive CVDs measures among MS patients, particularly among the women.
Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Elham
E
Jadidi
Mohammad
M
Mohammadi
Tahereh
T
Moradi
D000328:Adult; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors
Multiple sclerosis; Sweden; atrial fibrillation; cardiovascular disease; epidemiology; ethnicity; flutter; heart failure; immigrants; myocardial infarction; risk factors; stroke