Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis

Abstract

Aims: To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA). Methods: Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk. Results: Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10–0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients. Conclusion: Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.

A nemszteroid gyulladáscsökkentő szerek reumatológiai alkalmazása a cardiovascularis prevenció tükrében

“…Emiatt az Európai Reumatológus Liga (EULAR) a tradicionális cardiovascularis rizikó számolása során a reumatológiai betegeknél 1,5-es szorzó alkalmazását javasolja [8]. Axiális spondyloarthritisben a súlyosabb szerkezeti károsodás magasabb jósolható cardiovascularis rizikóval jár [9]. A betegeknél gyakoribb a dohányzás, a magas vérnyomás, az obesitas és a nemszteroid gyulladáscsökkentő gyógyszer szedése [9].…”

“…Axiális spondyloarthritisben a súlyosabb szerkezeti károsodás magasabb jósolható cardiovascularis rizikóval jár [9]. A betegeknél gyakoribb a dohányzás, a magas vérnyomás, az obesitas és a nemszteroid gyulladáscsökkentő gyógyszer szedése [9].…”

Effect of Secukinumab on Traditional Cardiovascular Risk Factors and Inflammatory Biomarkers: Post Hoc Analyses of Pooled Data Across Three Indications

“…Psoriasis, psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) are chronic immune-mediated, systemic inflammatory diseases closely associated with atherosclerotic cardiovascular disease (CV) disease [ 1 – 3 ]. The presence of CV comorbidities in these patients may contribute to increased mortality compared to the general population [ 1 , 4 , 5 ].…”

Acute Myocardial Infarction in a Young Male with Ankylosing Spondylitis – Case Presentation

“…Chronic inflammation can act alone or can be linked to traditional cardiovascular (CV) risk factors, including diabetes mellitus, hypercholesterolemia, obesity, smoking or hypertension, in the early onset of atherosclerosis (3). 1 Faculty of General Medicine, "Ovidius" University of Constanta 2 CF Hospital of Constanta 3 Constanta County Emergency Hospital It is mandatory to detect early and properly treat any of these risk factors, in order to reduce CV morbidy and mortality in AS patients (4).…”

“…Most of the patients with diabetes mellitus (DM) in childhood suffer from DM type 1 (DMT1) that is of autoimmune etiology [1,2]. This form of diabetes appears after the first 6 months of life, and reaches the highest incidence in the 9-14 years age group, with the rising incidence in the age group before 4 years of age [3]. The persisting hyper-glycemia is due to autoimmune destruction of insulin producing β-cells in the endocrine pancreas leading to insulin deficiency.…”