Background: Epicardial adipose tissue has been associated with the development of coronary artery disease and recently suggested as a novel marker for evaluating subclinical atherosclerosis.

Objectives: The aim of our study was to assess the relationship between EFT and cardiovascular risk parameters in patients with spondyloarthritis (SpA).

Methods: We performed a case control study including patients meeting ASAS 2009 criteria for SpA, and healthy controls. Subjects were aged less than 50years old and without traditional cardiovascular risk factors. Clinical features related to the disease were recorded. Anthropometric data (body mass index (BMI), waist circumference and hip circumference) and arterial blood pressure of the patients were also recorded. Blood specimens were collected after 12 hours of fasting and total cholesterol, HDL, LDL, triglyceride and fasting glucose were measured. Total cholesterol to HDL ratio and LDL to HDL ratio were calculated. All subjects underwent Doppler echocardiography with measurement of EFT by an experienced cardiologist.

Results: We enrolled 47 SpA patients and 47 controls. Subjects were age, sex and BMI matched (p=0.267, p=0.589 and p=0.238 repectively). Median disease activity scores BASDAI and ASDAS-CRP were 2.6 (IQR 25-75%: 1.8-3.8) and 2.18 (IQR 25-75%: 1.62-2.91) respectively. Median waist and hip circumference were 88 cm (IQR 25-75%: 82-97) and 100 cm (IQR 25-75%: 91-97), respectively. Median systolic (SBP) and diastolic (DBP) blood pressure were respectively 121 mmHg (IQR 25-75%: 110-130) and 71 mmHg (IQR 25-75%: 67-78). Laboratory findings showed a median fasting glucose level (FG) of 4.93 mmol/l (IQR 25-75%; 4.55-5.1). Median total cholesterol (CT), HDL, LDL and triglyceride levels were respectively 3.66 mmol/l (IQR 25-75%: 3.18-4.28), 1.08 mmol/l (IQR 25-75%: 0.92-1.2), 2.17 mmol/l (IQR 25-75%: 1.78-2.6) and 0.84 mmol/l (IQR 25-75%: 0.79-1.15). CT/HDL ratio and LDL/HDL ratio were 3.48 (IQR 25-75%: 2.95-3.97) and 1.99 (IQR 25-75%: 1.54-2.48), respectively.

Median EFT was significantly increased in patients compared to controls (3.1 mm (IQR: 2.5-4) versus 2.4 mm (IQR: 2-3), p=0.001).

A positive correlation was found between EFT and SBP (p=0.028; r=0.323) and triglyceride level (p=0.022, r=0.349). In contrast, EFT was not associated with DBP (p=0.069, r=0.270), BMI (p= 0.223, r=0.181), waist circumference (p=0.114, r=0.234), hip circumference (p=0.451, r=0.113), CT (p=0.127; r=0.236), HDL (p=0.587; r=0.085), LDL (p=0.342; r=0.149), FG (p=0.104, r=0.248), CT/HDL ratio (p=418; r=0.128) and LDL/HDL ratio (p=0.683;r=0.064).

In multivariate linear regression, triglyceride level was identified as an independently predictor of increased EFT (B=0.676; 95% confidence interval = 0.209-1.143; p= 0.006).

Conclusion: The importance of our results that we identified a traditional cardiovascular risk factor as a predictor of subclinical atherosclerosis in SpA without cardiovascular risk factor and with normal triglyceride level. This finding highlights the importance of regular screening for traditional cardiovascular risk parameters even if the disease in low activity.

Disclosure of Interests: None declared