oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Multiple sclerosis clinical course and cardiovascular disease risk: Swedish cohort study
Department of Neurology, Karolinska University Hospital Huddinge, Stockholm, Sweden; Neuroimmunology Unit, Centre for Molecular Medicine, Department of Clinical Neuroscience, Karolinska University Hospital Solna, Stockholm, Sweden; Clinical Epidemiology Unit and Centre for Pharmacoepidemiology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden.
Clinical Epidemiology Unit and Centre for Pharmacoepidemiology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden.
Department of Neurology, Karolinska University Hospital Huddinge, Stockholm, Sweden; Neuroimmunology Unit, Centre for Molecular Medicine, Department of Clinical Neuroscience, Karolinska University Hospital Solna, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden.
Neuroimmunology Unit, Centre for Molecular Medicine, Department of Clinical Neuroscience, Karolinska University Hospital Solna, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden.
Show others and affiliations
2014 (English)In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 21, no 11, p. 1353-e88Article in journal (Refereed) Published
Abstract [en]

Background and purpose: Cardiovascular disease (CVD) risk amongst multiple sclerosis (MS) patients appears raised, but few studies have examined CVD risk amongst an unselected MS patient group. MS course may be relevant for CVD risk. Our aim was to assess CVD risk and variation by course in MS patients.

Methods: The Multiple Sclerosis Register identified 7667 patients who received an MS diagnosis between 1964 and 2005. They were matched by age, period, region and sex with 76045 members of the general population without MS using Swedish registers. Poisson regression compared the two cohorts to estimate the relative risk for CVD, overall, as well as grouped and individual CVD diagnoses.

Results: MS patients had an increased adjusted relative risk (with 95% confidence intervals; number of MS cohort events) for CVD of 1.31 (1.22-1.41; n=847), with some variation by course: relapsing-remitting 1.38 (1.17-1.62; n=168); secondary progressive 1.30 (1.18-1.53; n=405) and primary progressive 1.15 (0.93-1.41; n=108). The association for the relapsing-remitting course was not significant after excluding the first year of follow-up. Overall incidence rates per 1000 person-years for CVD are 11.8 (11.06-12.66) for the MS cohort and 8.8 (8.60-9.05) for the non-MS cohort. The most pronounced association was for deep vein thrombosis: relapsing-remitting 2.16 (1.21-3.87; n=14), secondary progressive 3.41 (2.45-4.75; n=52) and primary progressive 3.57 (1.95-6.56; n=15). MS was associated with ischaemic stroke but largely during the first year of follow-up. MS was associated with a decreased relative risk for angina pectoris and atrial fibrillation.

Conclusions: There is a significantly increased relative risk for CVD in MS, particularly for venous thromboembolic disorders in progressive MS, suggesting immobility as a possible factor. An increased frequency of ischaemic stroke in MS is most probably due to surveillance bias resulting from diagnostic investigations for MS. There is no increased relative risk for ischaemic heart disease in MS and atrial fibrillation appears to be less common than amongst the general population. Click for the corresponding questions to this CME article.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014. Vol. 21, no 11, p. 1353-e88
Keywords [en]
cardiovascular disease, demyelinating diseases, multiple sclerosis, neurological disorders
National Category
Neurology
Research subject
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-39032DOI: 10.1111/ene.12518ISI: 000343808000004PubMedID: 25041631Scopus ID: 2-s2.0-84908664688OAI: oai:DiVA.org:oru-39032DiVA, id: diva2:766498
Available from: 2014-11-27 Created: 2014-11-27 Last updated: 2018-09-07Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Montgomery, Scott

Search in DiVA

By author/editor
Montgomery, Scott
By organisation
School of Health and Medical Sciences, Örebro University, SwedenÖrebro University Hospital
In the same journal
European Journal of Neurology
Neurology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 437 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf