{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:39:03Z","timestamp":1789439943197,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T00:00:00Z","timestamp":1405555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Cardiovascular disease (<jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>) risk amongst multiple sclerosis (<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>) patients appears raised, but few studies have examined <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk amongst an unselected <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> patient group. <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> course may be relevant for <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk. Our aim was to assess <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk and variation by course in <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Multiple Sclerosis Register identified 7667 patients who received an <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> diagnosis between 1964 and 2005. They were matched by age, period, region and sex with 76\u00a0045 members of the general population without <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> using <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>wedish registers. Poisson regression compared the two cohorts to estimate the relative risk for <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>, overall, as well as grouped and individual <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> patients had an increased adjusted relative risk (with 95% confidence intervals; number of <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> cohort events) for <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> of 1.31 (1.22\u20131.41; <jats:italic>n<\/jats:italic>\u00a0=\u00a0847), with some variation by course: relapsing\u2212remitting 1.38 (1.17\u20131.62; <jats:italic>n<\/jats:italic>\u00a0=\u00a0168); secondary progressive 1.30 (1.18\u20131.53; <jats:italic>n<\/jats:italic>\u00a0=\u00a0405) and primary progressive 1.15 (0.93\u20131.41; <jats:italic>n<\/jats:italic>\u00a0=\u00a0108). The association for the relapsing\u2212remitting course was not significant after excluding the first year of follow\u2010up. Overall incidence rates per 1000 person\u2010years for <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> are 11.8 (11.06\u201312.66) for the <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> cohort and 8.8 (8.60\u20139.05) for the non\u2010<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> cohort. The most pronounced association was for deep vein thrombosis: relapsing\u2212remitting 2.16 (1.21\u20133.87; <jats:italic>n<\/jats:italic>\u00a0=\u00a014), secondary progressive 3.41 (2.45\u20134.75; <jats:italic>n<\/jats:italic>\u00a0=\u00a052) and primary progressive 3.57 (1.95\u20136.56; <jats:italic>n<\/jats:italic>\u00a0=\u00a015). <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> was associated with ischaemic stroke but largely during the first year of follow\u2010up. <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> was associated with a decreased relative risk for angina pectoris and atrial fibrillation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a significantly increased relative risk for <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>, particularly for venous thromboembolic disorders in progressive <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>, suggesting immobility as a possible factor. An increased frequency of ischaemic stroke in <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> is most probably due to surveillance bias resulting from diagnostic investigations for <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>. There is no increased relative risk for ischaemic heart disease in <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> and atrial fibrillation appears to be less common than amongst the general population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12518","type":"journal-article","created":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T05:13:33Z","timestamp":1405574013000},"page":"1353","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Multiple sclerosis clinical course and cardiovascular disease risk \u2013 <scp>S<\/scp>wedish cohort study"],"prefix":"10.1111","volume":"21","author":[{"given":"H.","family":"Roshanisefat","sequence":"first","affiliation":[{"name":"Department of Neurology Karolinska University Hospital Huddinge Stockholm Sweden"},{"name":"Neuroimmunology Unit Centre for Molecular Medicine Department of Clinical Neuroscience Karolinska Institute and Karolinska University Hospital 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