| Popis: |
Background: Axial spondyloarthropathies (SpA) are associated with an increase in cardiovascular morbidity and mortality, showing an increase of 20% to 40% in the risk of cardiovascular events compared to the general population and constituting the main cause of death. The presence of subclinical atheromatosis, in the form of carotid plaques, is more frequent in patients with SpA than in healthy controls. Axial structural radiological damage in SpA is a consequence of the inflammatory activity of the disease. Objectives: To analyze whether axial radiological damage by mSASSS (Modified Stoke Ankylosing Spondylitis Spine Score) is related to cardiovascular risk factors or the presence of subclinical atheromatosis in patients with SpA. Methods: 195 patients diagnosed with SpA according to ASAS criteria without previous history of cardiovascular events or diabetes were assessed. The clinical characteristics, cardiovascular comorbidity, risk profile by Systematic Coronary Risk Evaluation (SCORE) and axial radiological damage (mSASSS score) were analyzed. The presence of plaques and intima-media thickness (cIMT) was determined by carotid ultrasound. The relationship between mSASSS and subclinical atheromatosis was analyzed by multivariate regression analysis. Results: 36% of patients with SpA showed presence of carotid plaque and a cIMT of 0.651 ± 0.121 mm. log mSASSS disclosed a positive univariate relationship with age (beta coefficient 0.07 [95% CI 0.06-0.08], p = 0.000) and classic cardiovascular risk factors such as abdominal waist, hypertension (0.73 [95% CI 0.31-1.16], p = 0.001), smoking (0.33 [IC95% 0.08-0.59], p = 0.010), SCORE (0.33 [IC95% 0.24-0.42], p = 0.000) and levels of C-reactive protein, glucose and C-peptide. Similarly mSASSS showed a positive relationship with the BASFI (0.18 [IC95% 0.11-0.26], p = 0.000) and BASMI (0.31 [IC95% 0.23-0.38], p = 0.000) scores, but not with ASDAS-CRP or BASDAI. The presence of carotid plaque (0.51 [95% CI 0.09-0.93], p = 0.018) and a higher cIMT (4.1 [IC95% 2.4-5.7], p = 0.000) were also significantly and positively related to a higher mSASSS. When these analyzes were performed in a multivariate phasion adjusting for age and sex, the relationships of log mSASSS with cardiovascular risk factors were lost, although the relationship of the former with BASFI, BASMI and SCORE remained statistically significant. With regard to subclinical atheromatosis, the relationship between log mSASSS and cIMT was not significant after the multivariate analysis; however, the presence of plaque showed an almost significant relationship after adjustment for age, sex and cardiovascular risk factors (0.34 [95% CI -0.42-0.73], p=0.081). Conclusion: Axial radiological damage through mSASSS is independently related to cardiovascular risk SCORE. A tendency to an independently significant relationship with the presence of carotid plaque was observed. Disclosure of Interests: None declared |
