Potential relation of cardiovascular risk factors to disease activity in patients with axial spondyloarthritis

Abstract

Background: Axial spondyloarthritis (axSpA) patients are known to have a higher prevalence of several comorbidities, including, among others, an increased risk of atherosclerosis, hypertension, dyslipidemia, and diabetes. The purpose of the present study was to determine whether the sum of traditional cardiovascular (CV) risk factors is related to disease characteristics, such as disease activity, in patients with axSpA. Methods: A cross-sectional study that encompassed 804 patients with axSpA was conducted. Patients were assessed for the presence of five traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking status), and disease activity measurements. A multivariable regression analysis was performed to evaluate whether the number of classic CV risk factors was independently associated with specific features of the disease, to include disease activity. Results: A multivariable analysis showed that Ankylosing Spondylitis Disease Activity Score–C reactive protein (ASDAS-CRP) activity score was significantly higher in patients with 1 [beta coefficient 0.3 (95% confidence interval (CI) 0.1–0.5), p = 0.001] and ⩾2 [beta coefficient 0.5 (95% CI 0.3–0.7), p = 0.000] CV risk factors compared with those without CV risk factors. Similarly, patients with 1 [OR 2.00 (95%CI 0.99–4.02), p = 0.053] and ⩾2 [OR 3.39 (95%CI 1.82–6.31), p = 0.000] CV risk factors had a higher odds ratio for the presence of high disease activity compared with the zero CV category. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) activity score was significantly associated with the number of CV risk factors, being higher in patients with more CV risk factors. These relationships showed a CV risk factor-dependent effect being beta coefficients and ORs higher for the effect of ⩾2 over 1 CV risk factor. Conclusion: Among patients with axSpA, as the number of traditional CV risk factors increased, disease activity similarly increases in an independent manner.

Factors associated with atherosclerosis in radiographic and non-radiographic axial spondyloarthritis. A multicenter study on 838 patients

“…It is widely accepted that systemic inflammation in IRD can significantly influence classic risk factors like dyslipidemia, insulin resistance, or obesity [35]. A recent study conducted on the AtheSpAin cohort reported that traditional CV risk factors were associated with higher disease activity also in patients with SpA [36]. It could be argued that this interconnection could explain the pro-atherogenic role played by the inflammation in our series.…”

Lifestyle modification and inflammation in people with axial spondyloarthropathy—A scoping review

“…Patients with AS live with other manifestations such as inflammatory bowel disease, psoriasis, and uveitis, contributing to a clustered disease burden (Zhu et al., 2019). Consequently, AS is associated with co‐morbidities such as cancer, infections, osteoporosis, and cardiovascular disease (CVD) (Ferraz‐Amaro et al., 2021). With respect to CVD, AS is associated with a higher incidence of hypertension, type 2 diabetes mellitus, obesity, and dyslipidaemia, which are considered classic risk factors for the development of CVD (Agca et al., 2017).…”

“…Patients with AS live with other manifestations such as inflammatory bowel disease, psoriasis, and uveitis, contributing to a clustered disease burden (Zhu et al, 2019). Consequently, AS is associated with co-morbidities such as cancer, infections, osteoporosis, and cardiovascular disease (CVD) (Ferraz-Amaro et al, 2021).…”

“…In fact, CVD is the leading cause of mortality in patients with AS (Moltó & Nikiphorou, 2018) and CRP may be the most important risk factor (Navarini et al., 2020). CRP concentrations are higher in patients with one or more CVD risk factors compared to those with none (Ferraz‐Amaro et al., 2021), and this correlates with higher disease activity in patients with AS (Ferraz‐Amaro et al., 2021).…”

The Evaluation of Cardiovascular Disease Risk Factors Knowledge Levels of Patients with Ankylosing Spondylitis

“…AS de artmış KVH riski ile ilişkilidir. [7][8][9][10][11][12] AS hastalarının mortalite oranları genel popülasyonun 1,5 katıdır. Bu hastalarda mortalitenin %20-40'ından kardiyovasküler olaylar sorumlu tutulmaktadır.…”