Ankylosing spondylitis is associated with increased prevalence of valvular heart diseases: a cross-sectional population-based study

Siwar Eid, Kassem Sharif, Dennis McGonagle, Yonatan Shneor Patt, Avishai M. Tsur, Mohammad Adawi, Arnon D. Cohen, Howard Amital, Abdulla Watad

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Background: Ankylosing spondylitis (AS) is a chronic inf lammatory arthritis primarily affecting the sacroiliac joint and axial skeleton with associated extra-articular involvement including cardiovascular system disease including aortic valve disease with variable reported prevalence. The aim of this study is to determine the prevalence of heart valve disorders in AS patients. Methods: This was a retrospective, population-based, cross-sectional study that retrieved data from the Clalit Health Services registry. Cases were defined as having AS, whereas controls were frequency matched by age and sex in a ratio of 5:1. The prevalence of valvular heart diseases was compared between the two groups; a multivariate logistic regression model was applied to estimate the association after controlling for potential confounders. Results: We included 4082 AS patients and 20 397 controls frequency matched by age and sex. AS patients had a significantly higher prevalence of cardiovascular risk factors (P < .001) and a higher prevalence of valvular heart disease. In the multivariate logistic regression model, adjusting for multiple confounding factors, AS was independently associated with aortic stenosis [odds ratio (OR): 2.25, 95% confidence interval (CI): 1.57–3.23, P < 0.001], aortic insufficiency (OR: 2.44, 95% CI: 1.50–3.94, P < 0.001), and mitral insufficiency (OR: 1.75, 95% CI: 1.17–2.61, P < 0.001) but not mitral stenosis (OR: 1.31, 95% CI: 0.60–2.70, P = 0.47). Conclusions: Our study reports the increased risk of valvular heart diseases in patients with AS, possibly due to the inf lammatory milieu associated with the disease process and the result of biomechanical stress affecting the enthesis-like valvular structures.

Original languageEnglish
Pages (from-to)1088-1093
Number of pages6
JournalPostgraduate Medical Journal
Issue number1176
StatePublished - 21 Sep 2023

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  • ankylosing spondylitis
  • aortic insufficiency
  • epidemiology
  • valvular heart diseases


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