Risk of coronary artery disease in patients with ankylosing spondylitis: a systematic review and meta-analysis.

Abstract

To investigate the association between coronary artery disease (CAD) and ankylosing spondylitis (AS). We conducted a systematic review and meta-analysis of observational studies that reported relative risks, hazard ratios, standardized prevalence ratio or standardized incidence ratios with 95% confidence comparing CAD risk in patients with AS versus non-AS controls. Pooled risk ratios and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance of DerSimonian and Laird. Out of 229 potentially relevant articles, ten studies (five retrospective cohort studies and five cross-sectional studies) were identified and included in our data analysis. The overall pooled risk ratio of CAD in patients with AS was 1.41 (95% CI: 1.29-1.54). The pooled risk ratios for cross-sectional and cohort studies were 2.08 (95% CI: 1.28-3.40) and 1.36 (95% CI: 1.31-1.41), respectively. The statistical heterogeneity of this meta-analysis was moderate with an I(2) of 56%. Our study demonstrated a statistically significant increased CAD risk among patients with AS with 41% excess risk.