Germany: Data from a recent study has suggested that patients with multiple sclerosis (MS) may be at a higher risk for heart failure and myocardial infarction (MI). The study appears in the journal Multiple Sclerosis and Related Disorders.
Several previous studies have described an association between MS and cardiovascular disease (CVD). However, the studies showed a high risk of bias due to the potential cardiotoxicity of disease-modifying treatments for MS, cardiovascular risk factors, and further sources of bias. Hence, the question of whether MS is a risk factor for CVDs remains elusive.
Against the above background, Daniel Rapp, Department of Neurology, University of Ulm, Ulm, Germany, and colleagues aimed to investigate the association between MS and acquired heart diseases in a systematic review and meta-analysis of non-randomized studies.
The researchers searched the online databases up to 5 October 2020 and included longitudinal studies comparing incident heart diseases between people with and without MS. ROBINS-E and the GRADE approach were used to assess the risk of bias and the certainty of evidence, respectively.
Nine studies met the inclusion criteria out of Of 5,159 studies examined.
The study revealed the following findings:
MS was associated with an increased risk for myocardial infarction (HR 1.6, n = 1,209,079) and heart failure (HR 1.7, n = 489,814).
The associations were more pronounced among women and younger people in subgroup analyses.
We found no difference for ischemic heart disease (HR 1.0, n = 679,378) and bradycardia (HR 1.5, n = 187,810).
The risk of atrial fibrillation was lower in people with multiple sclerosis (pwMS; HR 0.7, n = 354,070), but the risk of bias was high, and the certainty of evidence was rated as very low.
One study found more cases of infectious endocarditis among pwMS (HR 1.2, n = 83,712).
To conclude, the study was limited to a retrospective review of available literature; however, the results suggest that myocardial infarction and heart failure should be considered in people with multiple sclerosis during follow-up examinations.
Reference:
The study titled, "Associations between multiple sclerosis and incidence of heart diseases: Systematic review and meta-analysis of observational studies," was published in the journal Multiple Sclerosis and Related Disorders.
DOI: https://doi.org/10.1016/j.msard.2021.103279