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Vascular comorbidities in multiple sclerosis: a nationwide study from Denmark

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  1. High-intensity training in patients with spinal and bulbar muscular atrophy

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  2. Congenital myopathies are mainly associated with a mild cardiac phenotype

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  3. Relationship between muscle inflammation and fat replacement assessed by MRI in facioscapulohumeral muscular dystrophy

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  4. Guillain-Barré syndrome in Denmark: a population-based study on epidemiology, diagnosis and clinical severity

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  5. Peripheral neuropathy in hereditary spastic paraplegia caused by REEP1 variants

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  1. Illegal cannabis use is common among Danes with multiple sclerosis

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  2. Smoking is associated with increased disease activity during natalizumab treatment in multiple sclerosis

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  3. Infections seem to be more frequent before onset of pediatric multiple sclerosis: A Danish nationwide nested case-control study

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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.

Original languageEnglish
JournalJournal of Neurology
Volume263
Issue number12
Pages (from-to)2484-2493
Number of pages10
ISSN0340-5354
DOIs
Publication statusPublished - Dec 2016

ID: 49728940