Multiple Sclerosis Research Studies Open access Peer reviewed

Risk of macrovascular events among patients with ICD-defined neuromyelitis optica in Taiwan

Chih‐Jaan Tai, Kuang‐Hua Huang, Tsuei-Hung Wang, Tung-Han Tsai and 4 more

Frontiers in Neurology | Jul 1, 2026

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The risk of macrovascular events was compared between individuals with NMO and a matched population without NMO in Taiwan and NMO exhibited an elevated risk of CVD and CBD and was not associated with an elevated risk of certain CVDs.

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Background An elevated risk of cardiovascular disease (CVD) and cerebrovascular disease (CBD) has been observed in patients with ICD-defined Neuromyelitis Optica (hereinafter referred to as NMO). However, population-based research on this topic remains limited. In this study, the risk of macrovascular events was compared between individuals with NMO and a matched population without NMO in Taiwan. Methods Data for this retrospective cohort study were collected from a nationwide database in Taiwan. A total of 1,376 patients with new-onset NMO between 2003 to 2020 were enrolled. A Cox proportional hazards model was constructed to investigate CVD and CBD risk in patients with NMO and controlled for relevant variables. Results After relevant variables were controlled for, patients with NMO exhibited a significantly higher risk of CVD (adjusted hazard ratio [aHR] = 1.40; 95% confidence interval [CI] = 1.11–1.77) and CBD (aHR = 3.37; 95% CI = 2.69–4.22) than matched controls. Significant associations were observed between NMO and ischemic stroke, hemorrhagic stroke, and transient ischemic attack but not acute myocardial infarction, atrial fibrillation, coronary artery disease, or heart failure. Conclusion Individuals with NMO exhibited an elevated risk of CBD. Conversely, NMO was not associated with an elevated risk of certain CVDs.

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Chih‐Jaan Tai

first | China Medical University | ORCID 0000-0002-8000-2350

Kuang‐Hua Huang

middle | China Medical University | ORCID 0000-0003-4351-6202

Tsuei-Hung Wang

middle | Asia University

Tung-Han Tsai

middle | China Medical University

Shuo-Yan Gau

middle | Chia-Yi Christian Hospital

Vincent Ping-Sheng Lai

middle | Chung Shan Medical University

Zheng-Ren Lin

middle | Chung Shan Medical University Hospital

C Lee

last | Chung Shan Medical University Hospital

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BibTeX

@article{Tai2026Risk,
  title = {Risk of macrovascular events among patients with ICD-defined neuromyelitis optica in Taiwan},
  author = {Chih‐Jaan Tai and Kuang‐Hua Huang and Tsuei-Hung Wang and Tung-Han Tsai and Shuo-Yan Gau and Vincent Ping-Sheng Lai and Zheng-Ren Lin and C Lee},
  journal = {Frontiers in Neurology},
  year = {2026},
  doi = {10.3389/fneur.2026.1799026},
  url = {https://doi.org/10.3389/fneur.2026.1799026}
}

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