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The risk of venous thromboembolism in ankylosing spondylitis : a general population-based study Aviña-Zubieta, J. Antonio; Chan, Jonathan; De Vera, Mary; Sayre, E. C.; Choi, Hyon; Esdaile, John

Abstract

Background: Venous thromboembolism (VTE) including pulmonary embolism (PE) and deep vein thrombosis (DVT) can be life threatening. An increased frequency of VTE has been found in inflammatory conditions. To date, evidence assessing whether this risk is also greater in ankylosing spondylitis (AS) patients is scarce. Methods: Using the provincial British Columbia, Canada healthcare database that encompasses all residents within the province, we conducted matched cohort analyses of incident PE, DVT, and overall VTE amongst incident cases of AS and compared them with individuals randomly selected from the general population without AS. We calculated incidence rates of VTE and multivariable analyses after adjusting for traditional risk factors using Cox models. Results: Among 7,190 incident cases of AS, 35 developed PE and 47 developed DVT. Incidence rates (IR) of PE, DVT, and overall VTE per 1,000 person-years for AS patients were 0.79, 1.06, 1.56 compared with 0.40, 0.50, 0.77 in the control cohort. Corresponding fully adjusted HRs (95% CI) of PE, DVT, and VTE were 1.36 (0.92 to 1.99), 1.62 (1.16 to 2.26), and 1.53 (1.16 to 2.01). The risks of PE, DVT, and VTE were highest in the first year of diagnosis with HR (95% CI) of 2.88 (0.87 to 9.62), 2.20 (0.80 to 6.03), and 2.10 (0.88 to 4.99). Conclusions: These findings demonstrate an increased risk of VTE in the general AS population. This risk appears the most prominent in the first year after diagnosis.

Item Metadata

Title
The risk of venous thromboembolism in ankylosing spondylitis : a general population-based study
Creator
Aviña-Zubieta, J. Antonio; Chan, Jonathan; De Vera, Mary; Sayre, E. C.; Choi, Hyon; Esdaile, John
Date Issued
2019-02-08
Description
Background: Venous thromboembolism (VTE) including pulmonary embolism (PE) and deep vein thrombosis (DVT) can be life threatening. An increased frequency of VTE has been found in inflammatory conditions. To date, evidence assessing whether this risk is also greater in ankylosing spondylitis (AS) patients is scarce. Methods: Using the provincial British Columbia, Canada healthcare database that encompasses all residents within the province, we conducted matched cohort analyses of incident PE, DVT, and overall VTE amongst incident cases of AS and compared them with individuals randomly selected from the general population without AS. We calculated incidence rates of VTE and multivariable analyses after adjusting for traditional risk factors using Cox models. Results: Among 7,190 incident cases of AS, 35 developed PE and 47 developed DVT. Incidence rates (IR) of PE, DVT, and overall VTE per 1,000 person-years for AS patients were 0.79, 1.06, 1.56 compared with 0.40, 0.50, 0.77 in the control cohort. Corresponding fully adjusted HRs (95% CI) of PE, DVT, and VTE were 1.36 (0.92 to 1.99), 1.62 (1.16 to 2.26), and 1.53 (1.16 to 2.01). The risks of PE, DVT, and VTE were highest in the first year of diagnosis with HR (95% CI) of 2.88 (0.87 to 9.62), 2.20 (0.80 to 6.03), and 2.10 (0.88 to 4.99). Conclusions: These findings demonstrate an increased risk of VTE in the general AS population. This risk appears the most prominent in the first year after diagnosis.
Subject
Spondylitis; Ankylosing; Spondyloarthritis; Venous Thromboembolism; Deep Venous Thrombosis; Pulmonary Embolism; Thromboembolism; Risk; Observational studies
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2020-02-08
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0387571
URI
http://hdl.handle.net/2429/73209
Affiliation
Medicine, Faculty of; Pharmaceutical Sciences, Faculty of; Non UBC; Medicine, Department of
Citation
Aviña-Zubieta JA, Chan J, De Vera MA, Sayre EC, Choi HK, Esdaile JM. The risk of venous thromboembolism in ankylosing spondylitis: a general population-based study. Annals of the Rheumatic Diseases. 2019 Apr;78(4):480-485.
Publisher DOI
10.1136/annrheumdis-2018-214388
Peer Review Status
Reviewed
Scholarly Level
Faculty
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International