Background: Chronic inflammatory process seems to be the underlying cause contributing to atherosclerosis in spondyloarthritis. Epicardial adipose tissue (EAT) which is the accumulation of visceral fat between the myocardium and the visceral layer of pericardium, is actually considered a novel cardiometabolic risk predictor (1). Recent studies have shown its association with the development of coronary atherosclerosis.

Objectives: The aim of our study was to assess the epicardial fat thickness (EFT) in patients with spondyloarthritis (SpA) in comparaison with healthy subjects.

Methods: We performed a prospective study including 47 patients meeting ASAS 2009 criteria for SpA compared to 47 healthy controls matched for age, gender and body mass index (BMI). Patients with history of cardiovascular risk factors or diseases were not included. Sociodemographic, clinical, biological and radiographic features related to the disease were recorded. All subjects underwent transthoracic echocardiography with measurement of EFT.

Results: SpA group included 33 men and 14 women, with a median age of 36 years (IQR: 28-46). Median BMI was 24.5 kg/m ² (IQR: 20.7-26.8). Median systolic (SBP) and diastolic (DBP) blood pressure were respectively 121 mmHg (IQR: 110-130) and 71 mmHg (IQR: 67-78).

Median disease duration was 11 years (IQR: 5-16). Median disease activity scores BASDAI and ASDAS-CRP were 2.6 (IQR: 1.8-3.8) and 2.18 (IQR: 1.62-2.91) respectively. Median CRP level was 6.45 mg/l (IQR: 1.5-19.9). Median BASFI and BASMI were 3 (IQR: 1.5-5.1) and 1.5 (IQR: 0-4) respectively. Coxitis was found in 53% of patients. SpA patients received: NSAIDs (92%), csDMARDs (51%) and TNF inhibitors (38 %).

EFT was significantly increased in SpA patients compared with healthy controls; median EFT value was 3.1 mm (IQR: 2.5-4) versus 2.4 mm (IQR: 2-3) (p=0.001).

Conclusion: As an early marker of atherosclerosis, EFT was significantly higher in SpA patients, supporting clinical evidence of increased cardiovascular risk in SpA. Thus, more studies that involve larger samples should be conducted, using EFT to cardiovascular risk stratification in SpA.

REFERENCES:

[1]Katsiki N, Mikhailidis DP. Epicardial fat: a novel marker of subclinical atherosclerosis in clinical practice? Anatol J Cardiol. 2017 Jan;17(1):64–5.

Disclosure of Interests: None declared