Division of Rheumatology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
Arthritis Research Canada, Richmond, British Columbia, Canada.
Ann Rheum Dis. 2019 Apr;78(4):480-485. doi: 10.1136/annrheumdis-2018-214388. Epub 2019 Feb 8.
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep venous thrombosis (DVT), can be life threatening. An increased frequency of VTE has been found in inflammatory conditions. To date, evidence assessing whether this risk is also greater in patients with ankylosing spondylitis (AS) is scarce.
Using the provincial British Columbia, Canada healthcare database that encompasses all residents within the province, we conducted matched cohort analyses of incident PE, DVT and overall VTE among incident cases of AS and compared them with individuals randomly selected from the general population without AS. We calculated incidence rates (IRs) of VTE and multivariable analyses after adjusting for traditional risk factors using Cox models.
Among 7190 incident cases of AS, 35 developed PE and 47 developed DVT. IRs of PE, DVT and overall VTE per 1000 person-years for patients with AS were 0.79, 1.06, 1.56 compared with 0.40, 0.50, 0.77 in the control cohort. Corresponding fully adjusted HRs (95% CI) of PE, DVT and VTE were 1.36 (0.92 to 1.99), 1.62 (1.16 to 2.26) and 1.53 (1.16 to 2.01), respectively. The risks of PE, DVT and VTE were highest in the first year of diagnosis with HR (95% CI) of 2.88 (0.87 to 9.62), 2.20 (0.80 to 6.03) and 2.10 (0.88 to 4.99), respectively.
These findings demonstrate an increased risk of VTE in the general AS population. This risk appears the most prominent in the first year after diagnosis.
静脉血栓栓塞症（VTE），包括肺栓塞（PE）和深静脉血栓形成（DVT），可能危及生命。在炎症性疾病中发现 VTE 的频率增加。迄今为止，评估强直性脊柱炎（AS）患者的这种风险是否更大的证据很少。
我们使用不列颠哥伦比亚省、加拿大的省级医疗保健数据库，该数据库涵盖该省的所有居民，对新诊断的 AS 病例中的 PE、DVT 和总体 VTE 进行了匹配队列分析，并将其与没有 AS 的一般人群中随机选择的个体进行了比较。我们使用 Cox 模型在调整传统危险因素后计算了 VTE 的发病率（IR）和多变量分析。
在 7190 例新诊断的 AS 病例中，有 35 例发生了 PE，47 例发生了 DVT。AS 患者每 1000 人年发生 PE、DVT 和总体 VTE 的 IR 分别为 0.79、1.06 和 1.56，而对照组分别为 0.40、0.50 和 0.77。PE、DVT 和 VTE 的完全调整后的 HR（95%CI）分别为 1.36（0.92 至 1.99）、1.62（1.16 至 2.26）和 1.53（1.16 至 2.01）。在诊断后的第一年，PE、DVT 和 VTE 的风险最高，HR（95%CI）分别为 2.88（0.87 至 9.62）、2.20（0.80 至 6.03）和 2.10（0.88 至 4.99）。
这些发现表明，AS 患者的总体 VTE 风险增加。这种风险在诊断后的第一年最为明显。
