Iñigo González Mazón1, Javier Rueda-Gotor2, Iván Ferraz-Amaro3, Fernanda Genre4, Alfonso Corrales5, Vanesa Calvo Rio1, Natalia Palmou Fontana1, Virginia Portilla1, Javier Llorca6, Cristina Mata7, Vanesa Hernández-Hernández8, Juan Carlos Quevedo-Abeledo9, Carlos Rodríguez-Lozano10, Clementina Lopez Medina11, María Lourdes Ladehesa-Pineda12, Santos Castañeda13, Esther F Vicente14, Cristina Fernández-Carballido15, María Paz Martínez-Vidal16, David Castro-Corredor17, Joaquín Anino-Fernández18, Diana Peiteado19, Chamaida Plasencia-Rodríguez20, María Luz García-Vivar21, Eva Galíndez-Agirregoikoa22, Esther Montes Perez23, Carlos Fernández Díaz24, Ricardo Blanco25, Miguel Angel González-Gay26. 1. Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain. 2. Division of Rheumatology and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVAL, Av. de Valdecilla, 25, 39008 Santander, Cantabria, Spain. Electronic address: ruedagotor@gmail.com. 3. Rheumatology Division, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. 4. Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, IDIVAL, Santander, Spain. 5. Division of Rheumatology and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVAL, Av. de Valdecilla, 25, 39008 Santander, Cantabria, Spain. 6. Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IDIVAL, Santander, Spain. Electronic address: llorcaj@unican.es. 7. Rheumatology Division, Hospital Comarcal, Laredo, Cantabria, Spain. 8. Rheumatology Division, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. Electronic address: mvhhernandez@yahoo.es. 9. Rheumatology Division, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain. Electronic address: quevedojcarlos@yahoo.es. 10. Rheumatology Division, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain. Electronic address: crlormar@gmail.com. 11. Rheumatology Division, Hospital Universitario Reina Sofía, Córdoba, Spain. Electronic address: clementinalopezmedina@gmail.com. 12. Rheumatology Division, Hospital Universitario Reina Sofía, Córdoba, Spain. Electronic address: lourdesladehesapineda@gmail.com. 13. Rheumatology Division, Hospital Universitario de La Princesa, IIS-Princesa, Madrid, Spain. Electronic address: scastas@gmail.com. 14. Rheumatology Division, Hospital Universitario de La Princesa, IIS-Princesa, Madrid, Spain. Electronic address: efvicenter@gmail.com. 15. Rheumatology Division, Hospital Universitario de San Juan, Alicante, Spain. Electronic address: soficarballido@hotmail.com. 16. Rheumatology Division, Hospital General Universitario de Alicante, Alicante, Spain. Electronic address: mpmavidal@yahoo.es. 17. Rheumatology Division, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain. Electronic address: d.castrocorredor@gmail.com. 18. Rheumatology Division, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain. Electronic address: michaelturra@hotmail.com. 19. Rheumatology Division, Hospital La paz, Madrid, Spain. Electronic address: diana.peiteado@salud.madrid.org. 20. Rheumatology Division, Hospital La paz, Madrid, Spain. Electronic address: chamiplaro@gmail.com. 21. Rheumatology Division, Hospital Universitario Basurto, Bilbao, Spain. Electronic address: marialuz.garciavivar@osakidetza.eus. 22. Rheumatology Division, Hospital Universitario Basurto, Bilbao, Spain. Electronic address: eva.galindezaguirregoikoa@osakidetza.eus. 23. Diagnóstico Médico Cantabria (DMC), Santander, Spain. Electronic address: esmonpe13@hotmail.com. 24. Rheumatology división, Hospital 12 de Octubre, Madrid, Spain. Electronic address: carlos.fdez.diaz1@gmail.com. 25. Division of Rheumatology and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVAL, Av. de Valdecilla, 25, 39008 Santander, Cantabria, Spain. Electronic address: ricardo.blanco@scsalud.es. 26. Division of Rheumatology and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVAL, Av. de Valdecilla, 25, 39008 Santander, Cantabria, Spain; School of Medicine, University of Cantabria, Santander, Spain; Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, South Africa. Electronic address: miguelaggay@hotmail.com.
Abstract
OBJECTIVES: To compare the atherosclerosis disease burden between ankylosing spondylitis (AS) and non-radiographic (nr) axial spondyloarthritis (axSpA) and establish a model that allows to identify high-cardiovascular (CV) risk in axial spondyloarthritis patients. METHODS: Cross-sectional study from the AtheSpAin cohort, a Spanish multicenter cohort aimed to study atherosclerosis in axSpA. Carotid ultrasound (US) was performed to determine the carotid intima-media wall thickness (cIMT) and detect the presence of carotid plaques. The European cardiovascular disease risk assessment model, the Systematic COronary Risk Evaluation (SCORE), was also applied. RESULTS: A set of 639 patients with AS and 167 patients with nr-axSpA without history of CV events were recruited. AS patients were older showing more CV risk factors and higher values of C reactive protein and erythrocyte sedimentation rate (ESR) than those with nr-axSpA. However, no difference in the prevalence of carotid plaques or in the cIMT was found between both groups in the adjusted analysis. The percentage of patients reclassified from the low and moderate CV risk categories to the very high-risk category due to the presence of carotid plaques was comparable in AS and nr-axSpA (10.7% versus 10.1% and 40.5% versus 45.5%, respectively). A model containing age, BASFI and ESR applied to moderate risk axSpA patients identified 41% of these patients as having very high-risk patients with high specificity (88%). CONCLUSION: The atherosclerosis burden is similar in nr-axSpA and AS. As occurred for AS, more than 40% of axSpA patients included in the category of moderate CV risk according to the SCORE are reclassified into very high risk after carotid US, and a clinically relevant proportion of them can be detected by applying a model containing age, BASFI and ESR.
OBJECTIVES: To compare the atherosclerosis disease burden between ankylosing spondylitis (AS) and non-radiographic (nr) axial spondyloarthritis (axSpA) and establish a model that allows to identify high-cardiovascular (CV) risk in axial spondyloarthritispatients. METHODS: Cross-sectional study from the AtheSpAin cohort, a Spanish multicenter cohort aimed to study atherosclerosis in axSpA. Carotid ultrasound (US) was performed to determine the carotid intima-media wall thickness (cIMT) and detect the presence of carotid plaques. The European cardiovascular disease risk assessment model, the Systematic COronary Risk Evaluation (SCORE), was also applied. RESULTS: A set of 639 patients with AS and 167 patients with nr-axSpA without history of CV events were recruited. AS patients were older showing more CV risk factors and higher values of C reactive protein and erythrocyte sedimentation rate (ESR) than those with nr-axSpA. However, no difference in the prevalence of carotid plaques or in the cIMT was found between both groups in the adjusted analysis. The percentage of patients reclassified from the low and moderate CV risk categories to the very high-risk category due to the presence of carotid plaques was comparable in AS and nr-axSpA (10.7% versus 10.1% and 40.5% versus 45.5%, respectively). A model containing age, BASFI and ESR applied to moderate risk axSpA patients identified 41% of these patients as having very high-risk patients with high specificity (88%). CONCLUSION: The atherosclerosis burden is similar in nr-axSpA and AS. As occurred for AS, more than 40% of axSpA patients included in the category of moderate CV risk according to the SCORE are reclassified into very high risk after carotid US, and a clinically relevant proportion of them can be detected by applying a model containing age, BASFI and ESR.
Authors: Marta Rojas-Giménez; Clementina López-Medina; María Lourdes Ladehesa-Pineda; María Ángeles Puche-Larrubia; Ignacio Gómez-García; Jerusalem Calvo-Gutiérrez; Pedro Seguí-Azpilcueta; María Del Carmen Ábalos-Aguilera; Desirée Ruíz-Vilchez; Alejandro Escudero-Contreras; Eduardo Collantes-Estévez Journal: J Clin Med Date: 2022-01-27 Impact factor: 4.241