title: A nationwide population-based retrospective cohort study: increased risk of acute coronary syndrome in patients with ankylosing spondylitis.
abstract: OBJECTIVE
  To compare the risk of acute coronary syndrome (ACS) between patients with and without ankylosing spondylitis (AS).
  
  
  METHODS
  This retrospective cohort study identified all patients with AS aged ≥ 18 years newly diagnosed from 2000 to 2009, registered in the National Health Insurance Research Database (NHIRD) in Taiwan. The non-AS cohort consisted of fourfold randomly selected control patients free of AS, frequency matched by age, sex, and diagnosis year. The incidence of ACS was determined for both AS and non-AS cohorts.
  
  
  RESULTS
  We selected 6262 patients with AS and 25 048 patients without AS. The patients with AS were more prevalent than those without, with co-morbidities of hypertension, diabetes mellitus (DM), hyperlipidaemia, stroke, and peripheral vascular diseases. The overall incidence rate of ACS was higher in the AS cohort than in the non-AS cohort (4.4 vs. 2.9 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.36 [95% confidence interval (CI) 1.16-1.59]. AS patients with co-morbidities of hypertension, DM, and cancer had an aHR of 7.74 for ACS, compared to those without these co-morbidities.
  
  
  CONCLUSIONS
  AS patients are at higher risk of ACS compared with non-AS subjects. Management of CV risk factors should be taken into account for the treatment of patients with AS, especially for patients with co-morbidities of hypertension, DM, and cancer.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, YuanSheng Hospital and Changhua Christian Hospital, Yunlin Branch , Yunlin , Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Chou
authors.forename: M-C
authors.initials: MC
authors.lastname: Lin
authors.forename: C-L
authors.initials: CL
authors.lastname: Peng
authors.forename: Y-C
authors.initials: YC
authors.lastname: Wu
authors.forename: F-C
authors.initials: FC
authors.lastname: Sung
authors.forename: C-H
authors.initials: CH
authors.lastname: Kao
authors.forename: S-H
authors.initials: SH
authors.lastname: Liu
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; 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; D009369:Neoplasms / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult