Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study

Objectives To determine the incidence rate (IR) and predictors of myocardial infarction (MI) in patients with antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) as well as to estimate the IR ratio (IRR) of MI in AAV versus the background population.Methods 325 patients diagno...

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Main Authors: Moman Aladdin Mohammad, David Jayne, David Erlinge, Aladdin J Mohammad, Jens Rathmann, Ylva Borgas, Karl Gisslander
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/2/e005055.full
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author Moman Aladdin Mohammad
David Jayne
David Erlinge
Aladdin J Mohammad
Jens Rathmann
Ylva Borgas
Karl Gisslander
author_facet Moman Aladdin Mohammad
David Jayne
David Erlinge
Aladdin J Mohammad
Jens Rathmann
Ylva Borgas
Karl Gisslander
author_sort Moman Aladdin Mohammad
collection DOAJ
description Objectives To determine the incidence rate (IR) and predictors of myocardial infarction (MI) in patients with antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) as well as to estimate the IR ratio (IRR) of MI in AAV versus the background population.Methods 325 patients diagnosed with AAV 1997–2016 in Skåne, Sweden were included. Data were collected from the time of AAV diagnosis, and each patient was grouped with 10 age-matched and sex-matched reference subjects from the background population. MI after AAV diagnosis was identified using Swedish Web-System for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated According to Recommended Therapies and the Skåne Healthcare Register, and IR of first MI calculated. The IRR was computed by dividing the IR for 282 AAV patients by the corresponding rate in the 2763 reference subjects. Predictors of MI were analysed using Cox regression.Results 37 patients (11%) with AAV suffered an initial MI, yielding an IR of 1.6/100 person-years of follow-up (95% CI 1.2 to 2.2). The highest rate was recorded in the 3 months following AAV diagnosis, at 11.8/100 person-years (95% CI 6.2 to 22.7). The IRR of MI in AAV/reference was 1.9 (95% CI 1.3 to 2.8), highest in patients with myeloperoxidase-ANCA+disease (IRR 2.5, 95% CI 1.5 to 4.3) and those with high disease activity at diagnosis (2.1, 95% CI 1.3 to 3.3). Age at AAV diagnosis independently predicted MI.Conclusions The MI IR is greater in individuals diagnosed with AAV compared with background population, especially those with more severe disease, and highest in the 3 months following diagnosis. Age at diagnosis is the single independent predictor of MI in AAV in this study.
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spelling doaj-art-0647027ff52d4e1e80f9ae2d09c92c512025-08-20T01:47:26ZengBMJ Publishing GroupRMD Open2056-59332025-04-0111210.1136/rmdopen-2024-005055Myocardial infarction in ANCA-associated vasculitis: a population-based cohort studyMoman Aladdin Mohammad0David Jayne1David Erlinge2Aladdin J Mohammad3Jens Rathmann4Ylva Borgas5Karl Gisslander6Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenDepartment of Colorectal Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UKsenior consultant cardiologist and professor in cardiology, interventional cardiologistClinical Sciences, Rheumatology, Lund University, Lund, Skåne, SwedenDepartment of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenDepartment of Rheumatology, Skåne University Hospital, Malmo, SwedenDepartment of Clinical Sciences Lund, Rheumatology, Lund University, Lund, SwedenObjectives To determine the incidence rate (IR) and predictors of myocardial infarction (MI) in patients with antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) as well as to estimate the IR ratio (IRR) of MI in AAV versus the background population.Methods 325 patients diagnosed with AAV 1997–2016 in Skåne, Sweden were included. Data were collected from the time of AAV diagnosis, and each patient was grouped with 10 age-matched and sex-matched reference subjects from the background population. MI after AAV diagnosis was identified using Swedish Web-System for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated According to Recommended Therapies and the Skåne Healthcare Register, and IR of first MI calculated. The IRR was computed by dividing the IR for 282 AAV patients by the corresponding rate in the 2763 reference subjects. Predictors of MI were analysed using Cox regression.Results 37 patients (11%) with AAV suffered an initial MI, yielding an IR of 1.6/100 person-years of follow-up (95% CI 1.2 to 2.2). The highest rate was recorded in the 3 months following AAV diagnosis, at 11.8/100 person-years (95% CI 6.2 to 22.7). The IRR of MI in AAV/reference was 1.9 (95% CI 1.3 to 2.8), highest in patients with myeloperoxidase-ANCA+disease (IRR 2.5, 95% CI 1.5 to 4.3) and those with high disease activity at diagnosis (2.1, 95% CI 1.3 to 3.3). Age at AAV diagnosis independently predicted MI.Conclusions The MI IR is greater in individuals diagnosed with AAV compared with background population, especially those with more severe disease, and highest in the 3 months following diagnosis. Age at diagnosis is the single independent predictor of MI in AAV in this study.https://rmdopen.bmj.com/content/11/2/e005055.full
spellingShingle Moman Aladdin Mohammad
David Jayne
David Erlinge
Aladdin J Mohammad
Jens Rathmann
Ylva Borgas
Karl Gisslander
Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study
RMD Open
title Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study
title_full Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study
title_fullStr Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study
title_full_unstemmed Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study
title_short Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study
title_sort myocardial infarction in anca associated vasculitis a population based cohort study
url https://rmdopen.bmj.com/content/11/2/e005055.full
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