Ab0906 Risk of Acute Myocardial Infarction and Ischemic Stroke in Adults With Ankylosing Spondylitis: A Population-Based Study

Background: Several studies on the risks of fatal and non-fatal acute myocardial infarction (AMI) and stroke in adults with ankylosing spondylitis (AS) have been performed, but results (including subgroup analyses on age and sex) have been conflicting. Objectives: 1.To evaluate the risks of incident AMI and ischemic stroke in adults with newly diagnosed AS compared to matched general population controls. 2.To assess for differences in risk based on age and sex. Methods: We performed a population-based incident cohort study assessing risk of AMI and ischemic stroke among adults with AS compared to general population controls using administrative health data from British Columbia in a universal health care system. Data included diagnostic codes from physician visits and hospitalizations, all pharmacy-dispensed medications, and vital statistics. All incident cases with AS onset from January 1, 1997 to December 31, 2017, were identified based on ≥2 physician visits or hospitalizations with ICD9/10 codes 720.*/M45 and a run-in period of 7 years. General population controls without inflammatory arthritis were matched 2:1 on age, sex, and year of cohort entry. Individuals with prior AMI or stroke were excluded. Cohorts were followed until December 31, 2022, for occurrence of fatal or non-fatal AMI or ischemic stroke (defined by ICD9/10 codes in any position in hospital data or vital statistics). Cox proportional hazard regression models with propensity score overlap weighting (adjusting for potential confounders measured at baseline) and competing risk of death due to other causes were used to estimate hazard ratios (HRs) and 95% confidence intervals. Results: The cohort included 13,841 incident AS cases (52.6% males, mean age: 46.0) and 26,751 controls. Mean follow-up was 11.6 years. Risks of AMI and ischemic stroke were significantly higher in AS: weighted adjusted HRs for MI and stroke were 1.29 [1.18-1.42] and 1.16 [1.06-1.27], respectively (Table 1, Figure 1). The largest increases in risk were observed in females for both outcomes, in adults ≥50 years old for AMI, and in adults <50 for ischemic stroke (Table 1). Conclusion: AS is associated with an increased risk of AMI and ischemic stroke, particularly among females. These findings highlight the importance of detecting and managing traditional cardiovascular risk factors as well as controlling disease activity to prevent systemic complications of inflammation like AMI and stroke. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.