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Vascular comorbidities in multiple sclerosis: a nationwide study from Denmark

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Abstract

To investigate the occurrence of vascular comorbidities before and after the clinical onset of multiple sclerosis. In this combined case–control and cohort study, all Danish born citizens with onset of multiple sclerosis 1980–2005 were identified from the Danish Multiple Sclerosis Registry and randomly matched with controls regarding year of birth, gender, and municipality on January 1st in the year of multiple sclerosis (MS) onset (index date). Individual-level information on comorbidities was obtained from several independent nationwide registries and linked to the study population by unique personal identification numbers. To assess the presence of vascular comorbidities before and after MS onset, cases and controls were followed from January 1977 to the index date, and from the index date through December 2012. We used logistic regression to calculate odds ratios (ORs) and Cox regression to calculate hazard ratios (HRs). Before the index date, MS cases had a decreased probability for cerebrovascular comorbidity [OR 0.69 (95 % CI 0.48–0.99, p = 0.043)], and a numerically but not statistically significant decreased probability for cardiovascular comorbidity [OR 0.87 (95 % CI 0.71–1.07, p = 0.188)]. After the index date, MS cases had an increased risk for cerebrovascular comorbidity [HR 1.84 (95 % CI 1.69–2.00, p < 0.0005)], and for cardiovascular comorbidity [HR 1.08 (95 % CI 1.02–1.15, p = 0.013)]. The lower occurrence of cerebrovascular comorbidities in cases prior to MS onset could be due to protective immune mechanisms, while the higher occurrence of vascular comorbidities in cases after MS onset could be because of converging causal pathways of the coexisting diseases. These findings deserve to be studied closer in a broader spectrum of comorbidities in MS.

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Acknowledgments

This study was funded by the Danish Multiple Sclerosis Society.

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Authors and Affiliations

  1. Department of Neurology, Danish Multiple Sclerosis Center, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Anja Thormann, Melinda Magyari & Per Soelberg Sørensen

  2. The Danish Multiple Sclerosis Registry, Department of Neurology, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Anja Thormann, Melinda Magyari & Nils Koch-Henriksen

  3. Department of Clinical Epidemiology, Clinical Institute, University of Aarhus, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark

    Nils Koch-Henriksen

  4. The Danish National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353, Copenhagen K, Denmark

    Bjarne Laursen

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  1. Anja Thormann
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Correspondence to Anja Thormann.

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The manuscript does not contain clinical studies or patient data. The identity of persons in this study was encrypted, before the investigators gained access to data. Permission to process data was granted by The Danish Data Protection Agency; Capital Region ID 02,859, local number 30-1218.

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Thormann, A., Magyari, M., Koch-Henriksen, N. et al. Vascular comorbidities in multiple sclerosis: a nationwide study from Denmark. J Neurol 263, 2484–2493 (2016). https://doi.org/10.1007/s00415-016-8295-9

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  • DOI: https://doi.org/10.1007/s00415-016-8295-9

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