High risk of cardiovascular diseases after diagnosis of multiple sclerosis

Jadidi, Elham; Mohammadi, Mohammad; Moradi, Tahereh

doi:10.1177/1352458513475833

Cited by 118 publications

(167 citation statements)

References 36 publications

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“…We and others have shown a higher than expected incidence of cardiac disease in MS. 8,9 As hypothesized, we found that infection was a more common reason for ICU admission in the MS population than in the general population. Immunosuppressive therapy was associated with admission for infection, but adjusting for immunosuppressive therapies did not eliminate the association with admission for infection.…”

Section: Resultssupporting

confidence: 53%

“…[1][2][3][4] While chronic diseases are established risk factors for ICU admission and mortality, 5,6 little is known about the influence of immune-mediated diseases such as multiple sclerosis (MS) on ICU admissions. MS is associated with increased risks of infection 7 and ischemic heart disease, 8,9 which could increase the risk of ICU admission. However, hospitalized elderly patients with MS have been reported to be less likely to use intensive or coronary care services than other patients.…”

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confidence: 99%

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Intensive care unit admission in multiple sclerosis

et al. 2014

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Objective: To compare the incidence of, and mortality after, intensive care unit (ICU) admission as well as the characteristics of critical illness in the multiple sclerosis (MS) population vs the general population.Methods: We used population-based administrative data from the Canadian province of Manitoba for the period 1984 to 2010 and clinical data from 93% of admissions to provincial high-intensity adult ICUs. We identified 5,035 prevalent cases of MS and a cohort from the general population matched 5:1 on age, sex, and region of residence. We compared these populations using incidence rates and multivariable regression models adjusting for age, sex, comorbidity, and socioeconomic status.Results: From January 2000 to October 2009, the age-and sex-standardized annual incidence of ICU admission among prevalent cohorts was 0.51% to 1.07% in the MS population and 0.34% to 0.51% in matched controls. The adjusted risk of ICU admission was higher for the MS population (hazard ratio 1.45; 95% confidence interval [CI] 1.19-1.75) than for matched controls. The MS population was more likely to be admitted for infection than the matched controls (odds ratio 1.82; 95% CI 1.10-1.32). Compared with the matched controls admitted to ICUs, 1-year mortality was higher in the MS population (relative risk 2.06; 95% CI 1.32-3.07) and was particularly elevated in patients with MS who were younger than 40 years (relative risk 3.77; 95% CI 1.45-8.11). Causes of death were MS (9.3%), infections (37.0%), and other causes (52.9%). Conclusions:Compared with the general population, the risk of ICU admission is higher in MS, and 1-year mortality after admission is higher. Greater attention to preventing infection and managing comorbidity is needed in the MS population. Neurology ® 2014;82:2112-2119 GLOSSARY APACHE II 5 Acute Physiology and Chronic Health Evaluation II; CCI 5 Charlson Comorbidity Index; CI 5 confidence interval; HR 5 hazard ratio; ICD-9-CM 5 International Classification of Diseases, ninth revision, Clinical Modification; ICD-10 5 International Classification of Diseases, tenth revision; ICU 5 intensive care unit; IRR 5 incidence rate ratio; MS 5 multiple sclerosis; OR 5 odds ratio; SES 5 socioeconomic status.Intensive care units (ICUs) are an important component of hospital care, consuming a disproportionate share of medical costs in industrialized countries.1-4 While chronic diseases are established risk factors for ICU admission and mortality, 5,6 little is known about the influence of immune-mediated diseases such as multiple sclerosis (MS) on ICU admissions. MS is associated with increased risks of infection 7 and ischemic heart disease, 8,9 which could increase the risk of ICU admission. However, hospitalized elderly patients with MS have been reported to be less likely to use intensive or coronary care services than other patients. 10 The risk of ICU admission in the nonelderly MS population has not been studied, and outcomes after ICU admission are largely unknown.11 Knowledge of the characteristics and out...

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Section: Resultssupporting

confidence: 53%

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confidence: 99%

Intensive care unit admission in multiple sclerosis

et al. 2014

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“…Sternberg and colleagues also reported that there was no significant difference in the use of antihypertensive drugs between MS and non-MS patients. Lower prevalence of hypertension was also reported by some studies [19,54]. For example, in study of 8281 MS patients by Jadidi and his colleagues, the frequency of hypertension was lower in MS patients compared to the matched controls (0.42% versus 0.68%) [54].…”

Section: Prevalence Of Hypertension In People With Ms and Comparison mentioning

confidence: 54%

Vascular comorbidities in the onset and progression of multiple sclerosis

Tettey

Simpson

Taylor

et al. 2014

Journal of the Neurological Sciences

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“…Furthermore, while we have demonstrated associations between pain, depression, and CVD in individuals with SCI, the implications of our study have much broader clinical implications. Indeed, other neurological conditions, accompanied by neuropathic pain and depression in the early stages of disease, and high incidence of CVD at later time points (e.g., multiple sclerosis), may be subject to similar increased risk [28]. …”

Section: Discussionmentioning

confidence: 99%

Neuropathic Pain, Depression, and Cardiovascular Disease: A National Multicenter Study

et al. 2015

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Background: Individuals with spinal cord injury (SCI) have a more than twofold increased risk of heart disease and stroke compared with able-bodied individuals. The increased risk appears to be in excess of the risk conferred by several well-established risk factors, including diabetes, hypertension, and sex. This raises the question whether other factors, secondary to SCI, are also contributing to the development of cardiovascular disease (CVD). Two potential factors associated with SCI and CVD are pain and depression. Both are frequently reported among individuals with SCI, develop in the acute stages of injury, and are commonly described as severe. Therefore, the primary aim of this study was to examine the relationship betweenpain (and types of pain) and depression with CVD among individuals with SCI. Methods: A total of 1,493 individuals (referred sample) with chronic SCI participated in a self-report cross-sectional multicenter Canada-wide survey from 2011-2012 (mean age ± standard deviation: 49.6 ± 13.9 years). Results: After adjustment for age, sex, and injury characteristics, neuropathic pain and depression were significantly and independently associated with CVD (adjusted odds ratio and 95% confidence interval: 2.27 (1.21, 4.60) for neuropathic pain; 4.07 (2.10, 7.87) for depression). In contrast to neuropathic pain, non-neuropathic pain was not significantly associated with CVD (p = 0.13). Conclusion: In conclusion, these data illustrate important interrelationships between secondary complications following SCI, as well as raise the possibility of neuropathic pain (versus nociceptive pain) as a novel and emerging risk factor for CVD.

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High risk of cardiovascular diseases after diagnosis of multiple sclerosis

Abstract: We recommend careful surveillance and preventive CVDs measures among MS patients, particularly among the women.

Cited by 118 publications

References 36 publications

Intensive care unit admission in multiple sclerosis

Intensive care unit admission in multiple sclerosis

Vascular comorbidities in the onset and progression of multiple sclerosis

Neuropathic Pain, Depression, and Cardiovascular Disease: A National Multicenter Study

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