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Cardiovascular risk factors in secondary progressive multiple sclerosis: A cross-sectional analysis from the MS-STAT2 randomized controlled trial |
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| Authors: | Thomas Williams,Nevin John,Alberto Calvi,Alessia Bianchi,Floriana De Angelis,Anisha Doshi,Sarah Wright,Madiha Shatila,Marios C. Yiannakas,Fatima Chowdhury,Jon Stutters,Antonio Ricciardi,Ferran Prados,David MacManus,Marie Braisher,James Blackstone,Olga Ciccarelli,Claudia A. M. Gandini Wheeler-Kingshott,Frederik Barkhof,Jeremy Chataway,the UCL MS-STAT investigators |
| Affiliation: | 1. Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK;2. Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia;3. Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK National Institute for Health Research, Biomedical Research Centre, University College London Hospitals, London, UK;4. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK;5. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK Universitat Oberta de Catalunya, Barcelona, Spain;6. Comprehensive Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK;7. NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy;8. Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK National Institute for Health Research, Biomedical Research Centre, University College London Hospitals, London, UK Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK Department of Radiology & Nuclear Medicine, VU University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands |
| Abstract: | Background and purposeThere is increasing evidence that cardiovascular risk (CVR) contributes to disability progression in multiple sclerosis (MS). CVR is particularly prevalent in secondary progressive MS (SPMS) and can be quantified through validated composite CVR scores. The aim was to examine the cross-sectional relationships between excess modifiable CVR, whole and regional brain atrophy on magnetic resonance imaging, and disability in patients with SPMS.MethodsParticipants had SPMS, and data were collected at enrolment into the MS-STAT2 trial. Composite CVR scores were calculated using the QRISK3 software. Prematurely achieved CVR due to modifiable risk factors was expressed as QRISK3 premature CVR, derived through reference to the normative QRISK3 dataset and expressed in years. Associations were determined with multiple linear regressions.ResultsFor the 218 participants, mean age was 54 years and median Expanded Disability Status Scale was 6.0. Each additional year of prematurely achieved CVR was associated with a 2.7 mL (beta coefficient; 95% confidence interval 0.8–4.7; p = 0.006) smaller normalized whole brain volume. The strongest relationship was seen for the cortical grey matter (beta coefficient 1.6 mL per year; 95% confidence interval 0.5–2.7; p = 0.003), and associations were also found with poorer verbal working memory performance. Body mass index demonstrated the strongest relationships with normalized brain volumes, whilst serum lipid ratios demonstrated strong relationships with verbal and visuospatial working memory performance.ConclusionsPrematurely achieved CVR is associated with lower normalized brain volumes in SPMS. Future longitudinal analyses of this clinical trial dataset will be important to determine whether CVR predicts future disease worsening. |
| Keywords: | cardiovascular risk comorbidity multiple sclerosis progressive multiple sclerosis secondary progressive multiple sclerosis |