Ankylosing Spondylitis as a Risk Factor for Subsequent Ischemic Heart Disease: A Nationwide Cohort Study in South Korea.

OBJECTIVES

Ankylosing spondylitis (AS) is an autoimmune disorder marked by chronic inflammation that may accelerate atherosclerosis and increase ischemic heart disease (IHD) risk. This study assessed the association between AS and IHD using nationwide data.

METHODS

A retrospective historical cohort study was performed using Korean National Health Insurance Service data (2012-2023). AS was defined by the ICD-10 code M45 and the rare disease code V140. After a 3-year washout, IHD was defined as ≥2 visits with codes I20 to I25. Propensity score-matched controls (1:10) were selected, and proportional hazards models were applied.

RESULTS

A total of 2869 patients with AS and 28,690 matched controls were followed for a mean of 4.2 years. IHD occurred in 7.08% of patients with AS and 5.05% of controls. The incidence rate ratio (IRR) was 1.42 (95% CI: 1.23-1.65). Subgroup analyses revealed a higher risk among current smokers (IRR, 1.85). The risk increased with longer follow-up periods, especially in older men.

CONCLUSIONS

AS was significantly associated with elevated IHD risk, particularly among smokers and low-income groups. Early cardiovascular risk management is warranted.