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

Borgas, Ylva LU orcid ; Mohammad, Moman Aladdin LU orcid ; Gisslander, Karl LU orcid ; Rathmann, Jens LU orcid ; Erlinge, David LU orcid ; Jayne, David and Mohammad, Aladdin J. LU (2025) In RMD Open 11(2).
Abstract

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... (More)

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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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Granulomatosis with polyangiitis, Myocardial infarction, Vasculitis
in
RMD Open
volume
11
issue
2
article number
e005055
publisher
BMJ Publishing Group
external identifiers
  • scopus:105003793830
  • pmid:40250881
ISSN
2056-5933
DOI
10.1136/rmdopen-2024-005055
language
English
LU publication?
yes
additional info
Publisher Copyright: © Author(s) (or their employer(s)) 2025.
id
82290b07-31c7-4f86-a4d7-e52e87da27e7
date added to LUP
2025-09-03 12:43:24
date last changed
2025-09-03 14:02:55
@article{82290b07-31c7-4f86-a4d7-e52e87da27e7,
  abstract     = {{<p>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.</p>}},
  author       = {{Borgas, Ylva and Mohammad, Moman Aladdin and Gisslander, Karl and Rathmann, Jens and Erlinge, David and Jayne, David and Mohammad, Aladdin J.}},
  issn         = {{2056-5933}},
  keywords     = {{Granulomatosis with polyangiitis; Myocardial infarction; Vasculitis}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{2}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{RMD Open}},
  title        = {{Myocardial infarction in ANCA-associated vasculitis : A population-based cohort study}},
  url          = {{http://dx.doi.org/10.1136/rmdopen-2024-005055}},
  doi          = {{10.1136/rmdopen-2024-005055}},
  volume       = {{11}},
  year         = {{2025}},
}