ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1418

Impact of Type 2 Diabetes Mellitus on Cardiovascular Outcomes in Patients with Ankylosing Spondylitis on NSAID Therapy

Godbless Ajenaghughrure1, Sila Mateo Faxas2, Gurjot Singh3, Nirys Mateo Faxas4, Kim Nguyen3, Nicole Tejeda5 and Kimberly Ramirez Bonetti6, 1Trihealth Good Samaritan Hospital, Cincinnati, OH, 2Good Samaritan Hospital, Cincinnati, OH, 3Trihealth Good Samaritan Hospital, Cincinnati, 4Independent Author, Santo Domingo, Dominican Republic, 5Independent Author, Cincinnati, 6Independent Author, cincinnati, OH

Meeting: ACR Convergence 2025

Keywords:

Session Information

Date: Monday, October 27, 2025

Title: (1405–1433) Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Patients with ankylosing spondylitis (AS) have increased cardiovascular risk, potentially exacerbated by NSAID therapy. However, the additional impact of Type 2 diabetes mellitus (T2DM) in this population remains poorly characterized.

Methods: We conducted a retrospective cohort study using the TriNetX global federated health research network across 100 healthcare organizations. Two cohorts of adult patients (18-99 years) with AS on non-salicylate NSAIDs were analyzed: Cohort 1 with T2DM (n=9,499) and Cohort 2 without T2DM (n=9,499), propensity-score matched for demographic and clinical characteristics. Cardiovascular outcomes were assessed over a 5-year follow-up period (1825 days) after index date.

Results: Patients with AS on NSAID therapy and comorbid T2DM demonstrated significantly higher rates of major adverse cardiovascular events compared to matched patients without T2DM. Specifically, risk ratios (RR) and hazard ratios (HR) were significantly elevated for: mortality (RR 2.03, 95% CI 1.79-2.29; HR 1.95, 95% CI 1.72-2.21), cardiac arrest (RR 3.51, 95% CI 2.44-5.06; HR 3.37, 95% CI 2.34-4.86), atrial fibrillation (RR 2.97, 95% CI 2.60-3.39; HR 2.92, 95% CI 2.55-3.35), heart failure (RR 2.73, 95% CI 2.48-2.99; HR 2.76, 95% CI 2.50-3.04), cerebral infarction (RR 2.29, 95% CI 1.93-2.73; HR 2.59, 95% CI 2.02-3.32), and ventricular arrhythmias (RR 2.16, 95% CI 1.73-2.73; HR 2.09, 95% CI 1.66-2.64). Additionally, patients with T2DM had significantly higher rates of requiring pacemaker implantation (RR 2.44, 95% CI 2.09-2.84) and experiencing pulmonary complications including pulmonary hypertension (RR 2.26, 95% CI 1.93-2.64) and pulmonary embolism (RR 3.55, 95% CI 2.36-5.36).

Conclusion: T2DM significantly amplifies cardiovascular risk in patients with ankylosing spondylitis on NSAID therapy. This represents the largest analysis to date quantifying this increased risk across multiple cardiac outcomes. These findings highlight the need for enhanced cardiovascular monitoring and risk mitigation strategies in this high-risk population

Disclosures: G. Ajenaghughrure: None; S. Mateo Faxas: None; G. Singh: None; N. Mateo Faxas: None; K. Nguyen: None; N. Tejeda: None; K. Ramirez Bonetti: None.

To cite this abstract in AMA style:

Ajenaghughrure G, Mateo Faxas S, Singh G, Mateo Faxas N, Nguyen K, Tejeda N, Ramirez Bonetti K. Impact of Type 2 Diabetes Mellitus on Cardiovascular Outcomes in Patients with Ankylosing Spondylitis on NSAID Therapy [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/impact-of-type-2-diabetes-mellitus-on-cardiovascular-outcomes-in-patients-with-ankylosing-spondylitis-on-nsaid-therapy/. Accessed .

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