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No increase in atherosclerosis in patients with AS, low disease activity
Patients with ankylosing spondylitis were not at a higher risk for accelerated atherosclerosis, according to recently published research.
Sixty-seven patients with ankylosing spondylitis (AS) from the Laikon Hospital rheumatology outpatient clinic in Athens, Greece and 67 healthy participants matched for age, sex, smoking, lipids and blood pressure were enrolled in a study. Patients with AS were excluded in the presence of cardiovascular disease, chronic renal failure, diabetes or other severe disease.
Disease activity in patients with AS was assessed using the Bath AS Disease Activity Index (BASDAI), the Bath AS Functional Index (BASFI) and the Health Assessment Questionnaire Disability Index (HAQ-DI). Erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), glucose, lipids and other factors were measured within 3 months of examination.
After 12-hour fast, carotid hypertrophy, and subclinical atheromatosis, common carotid artery (CCA) elasticity and aortic stiffness were measured. Atheromatic plaques in a total of eight arterial beds (left and right, common and internal, carotid arteries and carotid bulb; and both common femoral arteries) were measured by ultrasound. Carotid hypertrophy in cross-section of the left and right common carotid arteries and carotid elasticity was measured with ultrasound. Carotid stiffness was measured using carotid-to-femoral pulse wave velocity (PWV) and pressure wave reflections by augmentation index with a SphygmoCor device (AtCor Medical). Echocardiogram-gated B-mode ultrasound was used to further measure carotid elasticity.
The patients with AS had an average BASDAI of 1.8, reflecting low disease activity. Hypertension was present in 33%, 15% had hyperlipidemia and 55% smoked. Most patients (66%) received tumor necrosis factor-alpha inhibitors.
The intima-media thickness was 0.79 in patients, 0.8 in control participants in the left CCA and 0.73 in patients with AS, and 0.73 in healthy patients in the right CCA. The PWV was 7.64 in patients with AS compared to 8.03 in healthy individuals. The augmentation index was 18.58 in patients with AS compared to 17.52 in control participants. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.