Background: Ankylosing spondylitis (AS) is associated with an increased cardiovascular risk (CVR), warranting accurate risk assessment. Among the available tools, the PROCAM, Framingham, SCORE, MONICA, and Globorisk scores are commonly used, but their relevance and temporal evolution in this population remain insufficiently explored.

Objectives: To compare the performance of the PROCAM, Framingham, SCORE, MONICA, and Globorisk scores in assessing CVR in patients with AS and to analyze the evolution of overall risk between two follow-up periods.

Methods: A cohort of 61 patients with AS was followed over 8 years (T0 and T1), along with 61 matched controls evaluated at T0. CVR scores were calculated at each time point. ROC analysis was used to evaluate their predictive performance. Changes in overall risk and the percentage of high-risk patients were analyzed using significance tests.

Results: Global CVR estimates showed a significant increase between T0 and T1 in AS patients for the SCORE (p = 0.000), PROCAM (p = 0.000), MONICA (p = 0.008), and Globorisk (p = 0.000) scores. At T1, the proportion of high-risk patients was significantly higher with SCORE (26.2% vs. 8.2% at T0, p = 0.001) and Globorisk (27.9% vs. 14.8% at T0, p = 0.004). ROC analysis revealed that PROCAM had the best predictive performance, with an AUC of 0.759 (95% CI: [0.675–0.843]), sensitivity of 77%, and specificity of 67.7%. SCORE achieved an AUC of 0.729 (95% CI: [0.638–0.820]) and high specificity (85.5%). MONICA, Framingham, and Globorisk demonstrated more modest performance, with AUCs of 0.655, 0.661, and 0.633, respectively.

Conclusion: The PROCAM score was the most effective in assessing CVR in AS patients. The upward trend in overall risk observed with several models, particularly SCORE and Globorisk, highlights the importance of longitudinal monitoring in this population. These findings call for tailored cardiovascular management strategies addressing the specificities of chronic inflammatory diseases.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.