J Korean Neurosurg Soc.  2019 Mar;62(2):217-224. 10.3340/jkns.2018.0110.

Association of Congestive Heart Failure and Death with Ankylosing Spondylitis : A Nationwide Longitudinal Cohort Study in Korea

• Bae KH
• Hong JB
• Choi YJ
• Jung JH
• Han IB
• Choi JM
• Sohn S

• KMID: 2441566
• DOI: http://doi.org/10.3340/jkns.2018.0110

Abstract

OBJECTIVE
We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death.
METHODS
We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities.
RESULTS
During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p < ;0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p < ;0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80-2.89) and 1.66 (95% CI, 1.42-1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups.
CONCLUSION
The incidence rates of congestive heart failure and death were increased in AS patients.

Keyword

Heart failure; Cardiovascular diseases; Death; Spondylitis, Ankylosing; Epidemiology

MeSH Terms

Cardiovascular Diseases
Cohort Studies*
Comorbidity
Diagnosis
Epidemiology
Estrogens, Conjugated (USP)*
Follow-Up Studies
Heart Failure*
Humans
Incidence
Korea*
National Health Programs
Spondylitis, Ankylosing*
Estrogens, Conjugated (USP)

Figure

• 

  Fig. 1. Procedure for establishment of the study cohort. Among the total population of the Republic of Korea (50455745 people), 15547 Ankylosing spondylitis (AS) subjects were extracted for the period, January 1, 2010 to December 31, 2014. One thousand four hundred subjects who had a previous history of ischemic stroke or acute myocardial infarction or congestive heart failure were excluded. Subsequently, 1159 people younger than 20 years old were also excluded. Eventually, 12988 subjects constituted the base cohort. NHIS : National Health Insurance Service.

• 

  Fig. 2. Comparison of the incidence probability of congestive heart failure between the Ankylosing spondylitis (AS) and control groups during the follow-up period. Kaplan-Meier curves with cumulative hazards of congestive heart failure were used in the AS and control groups. The incidence probability of congestive heart failure in the AS group was significantly higher than that in the control group (p<0.0001)

• 

  Fig. 3. Comparison of the incidence probability of death between the Ankylosing spondylitis (AS) and control groups during the follow-up period. Kaplan-Meier curves with cumulative hazards of death were used in the AS and control groups. The incidence probability of death in the AS group was significantly higher than that in the control group (p<0.0001).

Reference

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