Carmen García-Gómez1, María A Martín-Martínez2, Cristina Fernández-Carballido3, Santos Castañeda4, Carlos González-Juanatey5, Fernando Sanchez-Alonso2, María J González-Fernández6, Raimon Sanmartí7, Jesús A García-Vadillo4, Benjamín Fernández-Gutiérrez8, Miriam García-Arias9, Francisco J Manero10, José M Senabre11, Amalia Rueda-Cid12, Sergio Ros-Expósito13, José M Pina-Salvador14, Alba Erra-Durán15, Ingrid Möller-Parera16, Javier Llorca17, Miguel A González-Gay18. 1. Division of Rheumatology, Consorci Sanitari de Terrassa, Barcelona, Spain. 2. Research Unit of Spanish Society of Rheumatology, Madrid, Spain. 3. Division of Rheumatology, Hospital U. de Elda, Alicante, Spain. 4. Division of Rheumatology, Hospital U. de la Princesa, IIS-IP, Madrid, Spain. 5. Division of Cardiology, Hospital U. Lucus Augusti, Lugo, Spain. 6. Division of Rheumatology, Hospital Universitari Dexeus, Barcelona, Spain. 7. Division of Rheumatology, Hospital Clínic i Provincial, Barcelona, Spain. 8. Division of Rheumatology, Hospital Clínico San Carlos, Madrid, Spain. 9. Division of Rheumatology, Ponferrada, León, Spain. 10. Division of Rheumatology, Hospital Miguel Servet, Zaragoza, Spain. 11. Division of Rheumatology, Hospital Marina Baixa, La Vila Joiosa, Alicante, Spain. 12. Division of Rheumatology, Hospital General U. de Valencia, Spain. 13. Division of Rheumatology, Hospital de Viladecans, Barcelona, Spain. 14. Division of Rheumatology, Hospital de Barbastro, Huesca, Spain. 15. Division of Rheumatology, Hospital de Sant Rafael, Barcelona, Spain. 16. Division of Rheumatology, Instituto Poal, Barcelona, Spain. 17. University of Cantabria, IDIVAL, Santander, Spain, and CIBER Epidemiologia y Salud Pública (CIBERESP), Spain. 18. Epidemiology, Genetics & Atherosclerosis Res. Group on Systemic Inflammatory Diseases, Rheumatology Div., Hosp. Univ. Marqués de Valdecilla, IDIVAL, Univ. of Cantabria, Santander, Spain, and Univ. of the Witwatersrand, Johannesburg, South Africa.
Abstract
OBJECTIVES: Cardiovascular (CV) disease is one of the main causes of morbi-mortality in spondyloarthritis (SpA), partially explained by traditional CV risk factors. Information on lipoprotein(a) [Lp(a)], a non-conventional risk factor, in SpA is scarce. In this study we assessed the prevalence of hyperlipoproteinaemia(a) in SpA patients and analysed the possible related factors. METHODS: A baseline analysis was made of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients and controls included in the CARMA project (CARdiovascular in RheuMAtology), a 10-year prospective study evaluating the risk of CV events in chronic inflammatory rheumatic diseases. A multivariate logistic regression model was performed using hyperlipoproteinaemia(a) (Lp(a) >50 mg/dl) as a dependent variable and adjusting for confounding factors. RESULTS: 19.2% (95% CI: 16.80-22.05) of the SpA patients [20.7% (95% CI: 16.91-24.82) of those with AS and 17.7% (95% CI: 14.15-21.75) of those with PsA] and 16.7% (95% CI: 13.23-20.86) of the controls had hyperlipoproteinaemia(a) (p=0.326). Adjusting for age and sex, SpA patients were more likely to have hyperlipoproteinaemia(a) than controls (OR: 1.43, 95%CI: 1.00-2.04; p=0.05), especially those with AS (OR: 1.81, 95%CI: 1.18-2.77; p=0.007). In the adjusted model, apolipoprotein B in all patients, non-steroidal anti-inflammatory drugs in AS, and female sex in PsA, were associated with hyperlipoproteinaemia(a). No disease-specific factors associated with hyperlipoproteinaemia(a) were identified. CONCLUSIONS: SpA patients show a moderately increased risk of hyperlipoproteinaemia(a) compared to controls, especially those with AS. Lp(a) determination may be of interest to improve the CV risk assessment in SpA patients.
OBJECTIVES:Cardiovascular (CV) disease is one of the main causes of morbi-mortality in spondyloarthritis (SpA), partially explained by traditional CV risk factors. Information on lipoprotein(a) [Lp(a)], a non-conventional risk factor, in SpA is scarce. In this study we assessed the prevalence of hyperlipoproteinaemia(a) in SpA patients and analysed the possible related factors. METHODS: A baseline analysis was made of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients and controls included in the CARMA project (CARdiovascular in RheuMAtology), a 10-year prospective study evaluating the risk of CV events in chronic inflammatory rheumatic diseases. A multivariate logistic regression model was performed using hyperlipoproteinaemia(a) (Lp(a) >50 mg/dl) as a dependent variable and adjusting for confounding factors. RESULTS: 19.2% (95% CI: 16.80-22.05) of the SpA patients [20.7% (95% CI: 16.91-24.82) of those with AS and 17.7% (95% CI: 14.15-21.75) of those with PsA] and 16.7% (95% CI: 13.23-20.86) of the controls had hyperlipoproteinaemia(a) (p=0.326). Adjusting for age and sex, SpA patients were more likely to have hyperlipoproteinaemia(a) than controls (OR: 1.43, 95%CI: 1.00-2.04; p=0.05), especially those with AS (OR: 1.81, 95%CI: 1.18-2.77; p=0.007). In the adjusted model, apolipoprotein B in all patients, non-steroidal anti-inflammatory drugs in AS, and female sex in PsA, were associated with hyperlipoproteinaemia(a). No disease-specific factors associated with hyperlipoproteinaemia(a) were identified. CONCLUSIONS: SpA patients show a moderately increased risk of hyperlipoproteinaemia(a) compared to controls, especially those with AS. Lp(a) determination may be of interest to improve the CV risk assessment in SpA patients.