About a third of early AS patients (first 3 years from diagnosis), in the natural course of the disease, will chart a severe destructive and debilitating course early in the disease due to high disease activity, resulting in work loss.
Complications from AS can come from the disease itself (pain, deformities, disability, cardiovascular risks) or its treatment (NSAIDs with gastrointestinal bleed and cardiovascular risks, anti-TNFs with infection risks).
Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events? A prospective nationwide population-based cohort study
The unfortunate answer is "Yes": AS is associated with increased risk for heart attack, stroke and deep vein thrombosis. As in other chronic inflammatory conditions like RA, AS is not merely a pain condition which you can dismiss by being stoic.
Yes, there is solid proof that statins reduce mortality in those with increased risk from chronic inflammatory conditions like AS and PsA.