Carotid Intima-Media Thickness in Patients with Ankylosing Spondylitis: A Systematic Review and Updated Meta-Analysis

Yuan, Yaping; Yang, Jiajia; Zhang, Xu; Han, Renfang; Chen, Mengya; Hu, Xingxing; Ma, Yubo; Wu, Meng; Wang, Mengmeng; Xu, Shengqian; Pan, Faming

doi:10.5551/jat.45294

Cited by 21 publications

(25 citation statements)

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“…46 The cIMT was significantly increased in AS compared to healthy controls (standardized mean differences = 0.725, 95%CI = 0.443-1.008, P < .001) which is consistent with our results (WMD = 0.071, 95%CI = 0.048-0.094, P < .001). 46 It is worth mentioning that we have increased the sample size and the number of articles and added the analysis of PWV and FMD for the first time. Actually, in addition to cIMT, PWV, and FMD mentioned above, carotid plaque and coronary artery calcification could also reflect an advanced stage of atherosclerosis, indicating high cardiovascular risk and could be used as surrogate indicators for evaluating subclinical atherosclerosis.…”

Section: Discussionsupporting

confidence: 91%

“…10,14,26,44 Arida et al reviewed 12 studies concerning subclinical atherosclerosis and AS identified by cIMT and showed that AS may promote the development of CVD, especially in patients with AS of moderate or high disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] score !4). 45 In 2018, Yuan et al performed a meta-analysis on cIMT 46 ; 24 articles were collected. 46 The cIMT was significantly increased in AS compared to healthy controls (standardized mean differences ¼ 0.725, 95%CI ¼ 0.443-1.008, P < .001) which is consistent with our results (WMD ¼ 0.071, 95%CI ¼ 0.048-0.094, P < .001).…”

Section: Discussionmentioning

confidence: 99%

“…45 In 2018, Yuan et al performed a meta-analysis on cIMT 46 ; 24 articles were collected. 46 The cIMT was significantly increased in AS compared to healthy controls (standardized mean differences ¼ 0.725, 95%CI ¼ 0.443-1.008, P < .001) which is consistent with our results (WMD ¼ 0.071, 95%CI ¼ 0.048-0.094, P < .001). 46 It is worth mentioning that we have increased the sample size and the number of articles and added the analysis of PWV and FMD for the first time.…”

Section: Discussionmentioning

confidence: 99%

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The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis

Bai

Zhang

et al. 2018

Angiology

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Cardiovascular disease has become the first cause of death for patients with ankylosing spondylitis (AS). However, the relevant data is limited and the relationship between AS and subclinical atherosclerosis remains questionable. Therefore, we assessed the relationship between subclinical atherosclerosis and AS in this meta-analysis. We synthesized the primary data on flow-mediated vasodilation (FMD), carotid intima media thickness (cIMT), or pulse wave velocity (PWV)-related studies involving AS and using searched electronic databases. Not only were heterogeneity tests, publication bias, and sensitivity analysis performed overall, but also subgroup analysis and meta-regression grouped by measuring site, region, age, sex, and sample size were also carried out. A total of 35 articles involving 1535 patients with AS and 1347 normal controls were included. Significantly increased cIMT (weighted mean difference [WMD]; 95% confidence interval [CI]) ¼ 0.071 [0.048-0.094]), PWV (WMD [95%CI] ¼ 0.910 [0.464-1.356]), and decreased FMD (WMD [95%CI] ¼ À4.459 [À8.389 to À0.529]) were observed in patients with AS compared to controls. The funnel plots or Egger test or Begg test showed no significant publication bias (all P > .05). Sensitivity analysis did not show statistical significance. We conclude that patients with AS have a higher risk of subclinical atherosclerosis. Early screening and intervention deserves consideration.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis

Bai

Zhang

et al. 2018

Angiology

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“…Inflammation may have an impact on the development of accelerated atherosclerosis in AS [ 8 ], but an increased frequency of traditional risk factors (diabetes mellitus, hypertension, hyperlipidemia, and smoking) may also add to the risk of AMI [ 3 , 9 ]. Moreover, there are indications that patients with chronic inflammatory diseases might have an altered outcome after an CVD event [ 3 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics and outcome of a first acute myocardial infarction in patients with ankylosing spondylitis

et al. 2020

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Objectives To study clinical characteristics, mortality, and secondary prevention, after a first incident acute myocardial infarction (AMI) in patients with ankylosing spondylitis (AS) compared with the general population. Methods In total, 292 subjects with AS and a first AMI between Jan 2006 and Dec 2014 were identified using the Swedish national patient register. Each subject was matched with up to 5 general population comparators per AS-patient (n = 1276). Follow-up started at the date of admission for AMI and extended until death or 365 days of follow-up. Cox regression was used to assess mortality in two time intervals: days 0-30 and days 31-365. For a subgroup with available data, clinical presentation at admission, course, treatment for AMI, and secondary prevention were compared. Results During the 365-day follow-up, 56/292 (19%) AS patients and 184/1276 (14%) comparators died. There were no difference in mortality due to cardiovascular-related causes, although the overall mortality day 31-365 was increased among patients with AS compared with comparators (HR [95% CI] = 2.0 [1.3;3.0]). At admission, AS patients had a higher prevalence of cardiovascular comorbidities compared with comparators. At discharge, patients with AS were less often prescribed lipidlowering drugs and non-aspirin antiplatelet therapy. Conclusions Patients with AS tend to have a higher comorbidity burden at admission for first AMI. The mortality after a first AMI due to cardiovascular-related causes does not seem to be elevated, despite an increased overall mortality during days 31-365 among patients with AS compared with the general population. Keywords Acute myocardial infarction. Ankylosing spondylitis. Cardiovascular disease. Mortality Key Points • The all-cause mortality after a first AMI was higher in patients with AS. • Mortality after a first AMI due to CVD-related causes does not seem to be elevated for patients with AS. • In patients with AS suffering a first AMI, more attention should be given to other comorbidities causing an excess in mortality.

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“…Наиболее широко применяемыми в настоящее время неинвазивными методами являются измерение толщины комплекса интима-медиа (КИМ) общих сонных артерий (ОСА), которое дает возможность оценить начальные структурные изменения в артериальной стенке; определение эндотелий-зависимой вазодилатации (ЭЗВД) для диагностики эндотелиальной дисфункции (ЭД), предшествующей морфологическим изменениям сосудов и являющейся первым шагом в развитии атеросклероза, а также контурный анализ пульсовой волны, позволяющий охарактеризовать упруго-эластические свойства сосудистой стенки на различных участках артериального русла. В целом ряде исследований, ранее выполненных в популяции больных с АС, было показано наличие ЭД [16,17], утолщения КИМ ОСА [7,18] и увеличения скорости распространения пульсовой волны (СРПВ) как маркера артериальной ригидности (АР) [17]. Однако данные положения не нашли подтверждения в работах других авторов [13,19].…”

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Effect of golimumab on endothelial vasomotor function and arterial stiffness in ankylosing spondylitis

Князева

Damianov

Князева

et al. 2019

Naučno-praktičeskaâ revmatologiâ

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Objective: to evaluate the effect of golimumab (GLM) on endothelial vasomotor function and arterial stiffness in patients with ankylosing spondylitis (AS).Subjects and methods. A total of 42 patients with advanced-stage AS, who were older than 18 years and met the 1984 modified New York criteria with a disease duration of ≤5 years, were examined. The investigators visualized carotid arteries to determine local vascular wall stiffness, studied regional arterial stiffness to assess a pulse wave contour analysis, and a reactive hyperemia test before and after 104-week therapy.Results and discussion. RA patients without cardiovascular comorbidity were found to have signs of subclinical great artery involvement accompanied by endothelial vasoregulatory dysfunction in both the small resistance and large muscular arteries; by increases in common carotid artery (CCA) intima-media thickness (IMT) and stiffness index (SI); by rises in peripheral augmentation index (AIp), SI and reflection index (RI), the intensity of a change in which correlated with disease duration and activity assessed by ASDAS; as well as with the modified Schober test value, cervical rotation, and tragus-to-wall distance. In addition to a decrease in the Ankylosing Spondylitis Disease Activity Score (ASDAS), GML treatment in patients with AS caused a statistically significant increase in the amplitude occlusion index to the control values and a rise in the phase shift between the channels by an average of 2 times (p<0.01) as compared to the baseline values; a decrease in CCA IMT by an average by 20% (p=0.01) and in the local stiffness of the (carotid) vascular bed by 31% (p=0.01). The pulse wave contour analysis after 104-week GLM therapy revealed that AIp, SI and RI decreased by an average of 5 (р<0.001), 1.3 (р<0.01), and 2 (p<0.05) times, respectively, with the remaining statistically significant differences from the control values.Conclusion. In addition to the effectively reduced inflammatory activity, GLM therapy in patients with AS provides restoration of endothelial function in both the small resistance vessels (an increase in the amplitude occlusion index) and the large muscular arteries (a rise in the phase shift between the channels) and also has a vasoprotective effect on the wall of large elastic vessels (reductions in CCA IMT, SI, AIp, and SI) and small muscular arteries (a decrease in RI).

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Carotid Intima-Media Thickness in Patients with Ankylosing Spondylitis: A Systematic Review and Updated Meta-Analysis

Abstract: Carotid IMT was significantly increased in patients with AS compared with healthy controls, which suggested subclinical atherosclerosis is related to AS.

Cited by 21 publications

References 55 publications

The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis

The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis

Characteristics and outcome of a first acute myocardial infarction in patients with ankylosing spondylitis

Effect of golimumab on endothelial vasomotor function and arterial stiffness in ankylosing spondylitis

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