The prevalence of Myocardial Infarction among Multiple Sclerosis Patients: a Systematic Review and Meta-analysis

Background: People with multiple sclerosis (PwMS) are suggested to have a higher death rate compared to the overall population. Increased risk and incidence of cardiovascular diseases is a possible contributing factor here, as these patients are suggested to be more prone to early death due to myocardial infarction (MI). Aim: This systematic review aims to describe the prevalence of MI among PwMS in comparison to the non-MS population. Method: We thoroughly searched for publications reporting the prevalence of MI among PwMS in PubMed, Scopus, Embase, and Web of Science. We excluded studies focusing on the following conditions: ischemic heart disease only, autopsy of PwMS, MS patients with a previous history of cardiovascular diseases, and MS diagnosed after MI. Moreover, we excluded reviews, editorials, and commentaries. We used the random effect model to calculate the pooled prevalence. Results: We included nineteen studies, comprising 44 to 66616 participants. The overall prevalence of MI was 1.7% among PwMS. The pooled odds ratio estimate for MI was 1.41 in PwMS compared to the MS-free population. Conclusions: Results of this systematic review confirms the increased risk of MI among PwMS. Consequently, cardiovascular diseases should be considered in the management of these patients.