Ann Rheum Dis 69:579-581 doi:10.1136/ard.2009.110593
  • Clinical and epidemiological research
  • Concise report

Ankylosing spondylitis: a risk factor for myocardial infarction?

  1. M T Nurmohamed1,2,4
  1. 1Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands
  2. 2Department of Rheumatology, Jan van Breemen Institute Amsterdam, Amsterdam, The Netherlands
  3. 3NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
  4. 4Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Dr Michael T Nurmohamed, Departments of Internal Medicine and Rheumatology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, Netherlands; mt.nurmohamed{at}
  1. Contributors MJLP made substantial contributions to the concept and study design, analysed and interpreted the data and drafted the manuscript. IV analysed and interpreted the data, participated in the statistical analyses and has been involved in drafting the manuscript. MMJN participated in the statistical analyses and has been involved in drafting the manuscript. NVD collected the data. RAV, IEvdH-B and BACD critically revised the manuscript, and contributed to the intellectual content. MTN, leading investigator, contributed to the concept and study design, critically revised the manuscript, contributed to the intellectual content and revised the manuscript.

  • Accepted 21 April 2009
  • Published Online First 28 April 2009


Objective To ascertain the prevalence of myocardial infarction (MI) in ankylosing spondylitis (AS) relative to that in the general population.

Methods A questionnaire was sent to 593 patients with AS, aged between 50 and 75 years and registered at the Jan van Breemen Institute or VU University Medical Centre. A total of 383 (65%) patients with AS returned their questionnaire that covered the primary outcome, (non-fatal) MI. The prevalence of MI was calculated with data from the general population provided by Netherlands Information Network of General Practice databases as reference.

Results The overall prevalence for MI was 4.4% in patients with AS versus 1.2% in the general population, resulting in an age- and gender-adjusted odds ratio of 3.1 (95% CI 1.9 to 5.1) for patients with AS. When non-responders (35%) were considered as non-MI the odds ratio decreased to 1.9 (95% CI 1.2 to 3.2).

Conclusions These observations indicate that the prevalence of MI is increased in patients with AS.


  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the local ethical commission board (Slotervaart Hospital Amsterdam and VU University Medical Centre, Amsterdam).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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