Incident cardiovascular disease in patients diagnosed with multiple sclerosis: A multi-database study

Journal: Multiple Sclerosis and Related Disorders

Authors: Rebecca PerssonSally LeeMarianne Ulcickas YoodMichael WagnerNeil MintonSteve NiemcrykAnders LindholmAmber EvansSusan Jick

NLM Citation: Persson R, Lee S, Yood MU, Wagner M, Minton N, Niemcryk S, Lindholm A, Evans A, Jick S. Incident cardiovascular disease in patients diagnosed with multiple sclerosis: A multi-database study. Mult Scler Relat Disord. 2020 Jan;37:101423. doi: 10.1016/j.msard.2019.101423. Epub 2019 Oct 1. PMID: 32172996.

Abstract

Background: Recent data on rates of cardiovascular disease (CVD) in patients after MS diagnosis are sparse.

Objective: To describe incident CVD in MS patients after diagnosis compared with a matched non-MS population.

Methods: We conducted a matched cohort study in two separate electronic medical databases, the United States Department of Defense military health care system and the United Kingdom’s Clinical Practice Research Datalink GOLD. The study population included all patients with a first recorded diagnosis of MS and no history of CVD or selected measurable comorbidities associated with CVD and matched non-MS patients who were also free of CVD and the CVD associated comorbidities. We identified incident CVD outcomes first recorded after the MS diagnosis / matched date and calculated incidence rates and incidence rate ratios by type of CVD.

Results: Rates of venous thromboembolism and peripheral vascular disease were 2-fold higher among MS than non-MS patients in both databases and the risk of myocardial infarction was 2.5 times higher among female MS patients compared with non-MS females in both databases. Other CVD outcomes were not consistent between databases.

Conclusion: MS patients in the UK and the US have increased risk of venous thromboembolism and peripheral vascular disease. The risk of myocardial infarction is increased among female MS patients.

Keywords: Cardiovascular disease; Incidence; Multiple sclerosis; Myocardial infarction; Peripheral vascular diseases; Venous thromboembolism.