The following article is part of conference coverage from the Americas Committee for Treatment and Research in Multiple Sclerosis 2020 Forum in West Palm Beach, Florida. Neurology Advisor‘s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the ACTRIMS 2020 Forum.


WEST PALM BEACH, FL — Patients with vs without multiple sclerosis (MS) were found to be at increased risk for several cardiac events, according to study results presented at the 2020 Forum for Americas Committee for Treatment and Research in Multiple Sclerosis held February 27 to 29, 2020, in West Palm Beach, Florida.

Rates of cardiovascular disease (CVD) have not been extensively studied in patients following an MS diagnosis. In this study, the data of patients treated between 2004 and 2017 (n=6406 with MS; 66,281 healthy controls) from the United States Department of Defense database were examined. Patients and control individuals did not have CVD or CVD risk factors. Patients with MS had 1 or more year of medical history pre-MS diagnosis available, and were matched with up to 10 control individuals by age, gender, and geographic region.

Researchers identified incident cardiac outcomes recorded after the diagnosis date of multiple sclerosis or after the matched date for control individuals. The rates of CVD were found to be higher in patients with MS vs control individuals, with the exception of bradycardia. Incidence rate ratios (IRRs) were between 1.7 and 1.9 for angina, heart failure, and arrhythmia, and were elevated for stroke and transient ischemic attack. IRRs were more than double for: major adverse cardiac events (IRR, 2.09; 95% CI, 1.70-2.55), myocardial infarction (IRR, 2.11; 95% CI, 1.56-2.80), venous thromboembolism (IRR, 2.54; 95% CI, 2.14-3.00), and peripheral vascular disease (IRR, 2.49; 95% CI, 1.89-3.25).


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When stratified by sex, IRRs for myocardial infarction were higher in women with vs without MS, but not in men (IRR, 2.81; 95% CI, 1.92-4.01 and 1.37; 95% CI, 0.81-2.20, respectively). IRRs for major adverse cardiac events were elevated in women — and to a lesser extent in men — with vs without MS (IRR, 2.47; 95% CI, 1.92-3.13 and 1.55; 95% CI, 1.07-2.18, respectively).

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“Treated patients [with MS] have an increased risk [for] cardiac outcomes, most notably [venous thromboembolism, major adverse cardiac events, myocardial infarction, and peripheral vascular disease], compared with matched [patients without MS],”concluded the study authors.

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Reference

Persson R, Ulcickas Yood M, Wagner M, Evans A, Lee S, Minton S, et al. Cardiovascular disease in patients treated for multiple sclerosis: a study using the US Department of Defense Database. Presented at: Annual Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum; February 27-29, 2020; West Palm Beach, FL. Abstract P082.