Objective To examine the associations between exercise capacity (EC), cardiovascular (CV) risk factors and disease‐related variables in axial spondyloarthritis (AxSpA) patients. Methods In this cross‐sectional controlled study, CV risk profile data, physical activity, 10‐year CV event risk estimated by the Framingham model and Ankylosing Spondylitis Disease Activity Score – C‐reactive protein were recorded. A maximal treadmill exercise test by Bruce protocol was administered. Analyses of covariance were performed with adjustments for age, smoking status and physical activity level. Linear regression analysis was performed to study the association between EC and related CV risk factors. Results Thirty‐eight patients and 38 age‐gender matched controls were recruited between May and October 2014. Patients had significantly lower EC than controls (MD 2.2; metabolic equivalents 0.91‐3.49; P = .001). The difference remained significant after adjustments (P = .001). There were significant correlations between EC and age, 10‐year CV event risk, body mass index (BMI) and waist circumference for patients and controls (P < .001 and P < .05, respectively). There was a significant relationship between EC and total cholesterol, triglycerides and heart rate recovery (HRR) in patients (P = .04, P < .001 and P = .006, respectively). High‐density lipoprotein ‐ cholesterol was significantly higher, and BMI was significantly lower in nonradiographic AxSpA patients (P = .026 and P = .03 respectively). Age and triglyceride levels were found as the significant predictors for EC in the AxSpa group (for age β = −.105, P = .003; for triglycerides β = −.016 P = .003). Conclusion Exercise capacity was significantly lower and attenuated HRR was significantly associated with low EC and high 10‐year CV event risk in AxSpA patients.

Purpose In patients with a cardiac pacemaker, pocket-related complications such as nerve impairment or bone fractures are infrequent. We present a man with a fracture of the 4th rib several months after pacemaker implantation. Case presentation A 74-year-old man, with a left prepectoral pacemaker implanted 13 months ago, presented complaining of chest pain. The pain started after a sudden trunk rotation and right arm flexion movement with a crack. There was tenderness to palpation and crepitation over the left upper ribs. Computed tomography identified a non-displaced fracture line in the anterior aspect of the left 4th rib. After kinesiotaping and activity restriction, pain alleviated. Conclusion Pacemaker implantation might have caused shoulder dysfunction and pectoral tightness resulting in reduced flexibility of the trunk. Consequently, a reaching motion of the arm with a trunk rotation might have directed rotational force vectors towards the osteopenic left 4th rib causing a fragility fracture. In elderly with a pacemaker, osteopenia and concomitant sarcopenia may create a predisposition to this atypical complication.