fetching data ... 
Background: Cardiovascular morbidity and mortality are increased in spondyloarthritis (SpA) (1), which is attributed to accelerated atherosclerosis. Recognition of subclinical atherosclerosis in asymptomatic population is important for risk stratification and optimal management. Due to its simplicity and non-invasive nature, carotid intima-media thickness (cIMT) is actually widely used for identifying subclinical atherosclerosis.
Objectives: The aim of our study was to investigate the presence of subclinical atherosclerosis in SpA patients compared with healthy controls, by evaluating cIMT.
Methods: We performed a case control study including 47 patients and 47 age and gender matched healthy controls. All subjects were included without history of cardiovascular disease or cardiovascular risk factors. Sociodemographic features, disease characteristics, radiographic structural damage and therapeutics were recorded. cIMT was measured with Mindray Resona 7 ZST+ ultrasound machine, from the right and the left carotid artery; than mean cIMT was calculated. We considered that cIMT was increased if the measurements were between 0.7 mm and 1.5 mm. Measurements higher than 1.5 were defined as an atherosclerotic plaque.
Results: Fourty seven patients with a sex ratio of 2.35 were included in our study. Median age was 36 years (IQR: 28-46) and median duration of the disease was 11 years (IQR: 5-16). Median BASDAI and ASDAS-CRP scores were 2.6 (IQR: 1.8-3.8) and 2.18 (IQR: 1.62-2.91) respectively. Of the 47 patients, 10 (21%) had an active disease according to BASDAI and 19 (40%) had an active disease according to ASDAS. Median BASFI score for functional impairment was 3 (IQR: 1.5-5.1). Median BASRI and mSASSS scores were 3 (IQR: 2-4) and 10 (IQR: 4-15) respectively. Regarding treatment, 92% of patients were using non-steroidal anti-inflammatory drugs (NSAIDs), 51% were on csDMARDs and 38% were on anti-TNF alpha drugs.
Median right, left and mean cIMT were respectively 0.54 mm (IQR: 0.50-0.63), 0.55 mm (IQR: 0.49-0.61) and 0.55 mm (IQR: 0.48-0.62) respectively. Increased cIMT values were found in 8 patients (17%). No patient had atherosclerotic plaque.
Median values of cIMT were significantly higher in patients with spondyloarthritis than the control subjects (p<0.0001) as shown in
Comparaison of carotid intima-media thickness values between spondyloarthritis patients and control subjects.
| SpondyloarthritisPatients | Control group | p | |
|---|---|---|---|
| Right cIMT (mm)* | 0,54 (0,50-0,63) | 0,45 (0,42-0,50) | < 0.0001** |
| Left cIMT (mm)* | 0,55 (0,49-0,61) | 0,47 (0,45-0,50) | <0.0001** |
| Mean cIMT (mm)* | 0,55 (0,48-0,62) | 0,46 (0,43-0,50) | <0.0001** |
cIMT: carotid intima-media thickness; mm: millimeters; *: median value (IQR 25-75%); **: p < 0.05 denotes statistical significance.
Conclusion: Our study demonstrated increased cIMT in patients with SpA compared with healthy population; which attests higher risk for subclinical atherosclerosis and cardiovascular atherosclerotic events.
REFERENCES:
[1]Bai R, Zhang Y, Liu W, Ma C, Chen X, Yang J, et al. The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis. Angiology. 2019 Jul;70(6):492–500.
Disclosure of Interests: None declared