Factors associated with atherosclerosis in radiographic and non-radiographic axial spondyloarthritis. A multicenter study on 838 patients.
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Rueda-Gotor Javier, Ferraz-Amaro Iván, Genre Fernanda, González-Mazón Iñigo, Corrales Alfonso, Calvo-Rio Vanesa, Portilla Virginia, Llorca Javier, Expósito Rosa, Hernández-Hernández Vanesa, Quevedo-Abeledo Juan Carlos, Rodríguez-Lozano Carlos, Lopez-Medina Clementina, Ladehesa-Pineda María Lourdes, Castañeda Santos, Vicente Esther F, Fernández-Carballido Cristina, Martínez-Vidal M Paz, Castro-Corredor David, Anino-Fernández Joaquín, Peiteado Diana, Plasencia-Rodríguez Chamaida, García-Vivar María Luz, Galíndez-Agirregoikoa Eva, Montes-Perez Esther, Fernández-Díaz Carlos, Blanco Ricardo, González-Gay Miguel Ángel
Аннотация
METHODS: This is a cross-sectional observational study of the AtheSpAin cohort, a Spanish multicenter cohort to study atherosclerosis in axSpA. Subclinical atherosclerosis determined by carotid ultrasound included assessment of carotid intima-media thickness (cIMT) and plaque detection.
RESULTS: 639 AS and 167 nr-axSpA patients were recruited. CV risk factors (CRF) and several disease-related factors showed a statistically significant association with subclinical atherosclerosis in the crude analysis. After adjustment for age, sex, and smoking (model 1), associations remained statistically significant for spinal mobility, inflammatory bowel disease, use of prednisone, and Disease-modifying antirheumatic drugs (DMARD) when assessing carotid plaques and for acute phase reactants (APR) at diagnosis, use of prednisone, DMARD, and TNF-inhibitors when measuring cIMT. In model 2, which also included classic CRF as confounding factors to identify axSpA features with a potential independent pro-atherogenic effect, the functional status was the only variable significantly associated with plaques and the use of prednisone and APR at diagnosis with cIMT. No association differences were found between both subtypes of patients. Besides, APR at diagnosis were also associated with subsequent development of CV events that had occurred in 33 patients.
CONCLUSION: Apart from CRF, atherosclerotic disease in AxSpA is associated with disease-related factors such as inflammatory response and disease severity, with no differences between AS and nr-axSpA.