Multiple sclerosis and vascular nexus: A systematic review and meta-analysis of incidence and mortality - 18/03/25
, E. Ellouz a, bHighlights |
• | The vascular disease incidence in MS cases was significantly higher than controls. |
• | MS patients exhibited a significantly higher risk of heart failure, venous thromboembolism, peripheral vascular disease, and stroke. |
• | Subgroup analysis according to follow-up period showed that the highest incidence risk of vascular disease was within the first 10years of follow-up. |
• | MS seems to play a protective role for atrial fibrillation/flutter and high blood pressure. |
• | Vascular disease mortality ranked third among causes of death in MS patients, following MS itself, infectious diseases, and respiratory diseases. |
Abstract |
Background |
Vascular diseases (VDs) are increasingly studied in multiple sclerosis (MS) due to their significant impact on disability and mortality. Our aim was to evaluate VD incidence rates and determine the prevalence of VD-related mortality.
Material and methods |
Our study followed the PRISMA 2020 guidelines. We searched PubMed, Google Scholar, Europe PMC, and Web of Science from the inception up to April 30th, 2024. Data analysis was performed using the R statistics package program. Sensitivity analysis, subgroup analysis, and meta-regression were conducted for significant heterogeneity.
Results |
We collected 23 studies. Patients with MS exhibited significantly higher rates of VD compared with controls. Patients with MS showed a significantly higher rate of heart failure (HF), venous thromboembolism (VTE), peripheral vascular disease (PVD), and stroke, although the incidence rate of atrial fibrillation/flutter was significantly lower compared with controls. High blood pressure tended to be lower compared with controls. The highest rate of VD was within the first 10years of follow-up, significantly for myocardial infraction, VTE, and stroke, compared with controls. Regarding mortality, the prevalence of VD-related mortality among deceased individuals with MS was 16.7% [95% CI 11.8;22.0].
Conclusion |
Our meta-analysis revealed a significant dynamic nexus between MS and VD. MS may act as an independent risk factor for certain VDs, yet it could also be a protective factor against others. Physicians should consider VD and mortality related to VD when managing patients with MS.
Le texte complet de cet article est disponible en PDF.Keywords : Multiple sclerosis, Vascular disease, Mortality, Incidence, Prevalence
Plan
Vol 181 - N° 3
P. 184-199 - mars 2025 Retour au numéro
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