Factors associated with atherosclerosis in radiographic and non-radiographic axial spondyloarthritis. A multicenter study on 838 patients

Rueda-Gotor, Javier; Ferraz‐Amaro, Iván; Genre, Fernanda; González-Mazón, I.; Corrales, Alfonso; Calvo-Río, V.; Portilla, Virginia; Llorca, Javier; Expósito, Rosa; Hernández-Hernández, Vanesa; Quevedo-Abeledo, Juan Carlos; Rodríguez‐Lozano, Carlos; López-Medina, C.; Ladehesa-Pineda, Lourdes; Castañeda, Santos; Vicente, Esther; Fernández‐Carballido, Cristina; Martínez-Vidal, María Paz; Corredor, David Castro; Anino-Fernández, Joaquín; Peiteado, Diana; Plasencia-Rodríguez, Chamaida; García-Vivar, María Luz; Galíndez-Agirregoikoa, E.; Montes-Perez, Esther; Fernández-Díaz, C.; Blanco, Ricardo

doi:10.1016/j.semarthrit.2022.152037

Cited by 8 publications

(7 citation statements)

References 41 publications

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“…High disease activity is associated with CVD. A multicenter study from Spain found that CRP > 3 mg/L and ESR at the time of diagnosis were significantly associated with CIMT, a surrogate marker of atherosclerosis [81]. Another study from Italy showed that the persistence of increased CRP levels and high disease activity (BASDAI > 4 or ASDAS > 2.1) are associated with increased CVD [82].…”

Section: Inflammation and (Subclinical) Cardiovascular Diseasementioning

confidence: 99%

Cardiovascular Disease and Cardiac Imaging in Inflammatory Arthritis

Madenidou

Mavrogeni

Nikiphorou

2023

Life

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Cardiovascular morbidity and mortality are more prevalent in inflammatory arthritis (IA) compared to the general population. Recognizing the importance of addressing this issue, the European League Against Rheumatism (EULAR) published guidelines on cardiovascular disease (CVD) risk management in IA in 2016, with plans to update going forward based on the latest emerging evidence. Herein we review the latest evidence on cardiovascular disease in IA, taking a focus on rheumatoid arthritis, psoriatic arthritis, and axial spondylarthritis, reflecting on the scale of the problem and imaging modalities to identify disease. Evidence demonstrates that both traditional CVD factors and inflammation contribute to the higher CVD burden. Whereas CVD has decreased with the newer anti-rheumatic treatments currently available, CVD continues to remain an important comorbidity in IA patients calling for prompt screening and management of CVD and related risk factors. Non-invasive cardiovascular imaging has been attracting much attention in view of the possibility of detecting cardiovascular lesions in IA accurately and promptly, even at the pre-clinical stage. We reflect on imaging modalities to screen for CVD in IA and on the important role of rheumatologists and cardiologists working closely together.

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Section: Inflammation and (Subclinical) Cardiovascular Diseasementioning

confidence: 99%

Cardiovascular Disease and Cardiac Imaging in Inflammatory Arthritis

Madenidou

Mavrogeni

Nikiphorou

2023

Life

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“…While certain CV risk factors like age, sex, and family history are non-modifiable, the five primary traditional and modifiable risk factors—hypertension, smoking, dyslipidemia, diabetes, and obesity—account for over 50% of all CV deaths in SpA patients [ 1 , 2 , 11 , 12 ]. Therefore, identifying these factors and implementing control measures are crucial in managing the disease and averting morbidity and mortality in SpA patients [ 1 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Atherosclerosis-related CV events, such as ischemic heart disease, stroke, and myocardial infarction, are the prevalent disease conditions for SpA patients [ 5 , 13 – 16 ]. Studies have indicated a positive correlation between the number of risk factors and the occurrence of CV disease (CVD) [ 2 , 11 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have indicated a positive correlation between the number of risk factors and the occurrence of CV disease (CVD) [ 2 , 11 , 17 ]. The complex relationship between CV risk factors, treatment approaches, disease-related features, and increased mortality in SpA patients warrants further exploration [ 1 , 5 , 11 , 13 ]. Besides the considerable variations in the significance of such relationships for each country, the studies investigating these issues in the same patient groups, including all phenotypes of SpA, are limited in number [ 1 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Cross-sectional analysis of cardiovascular disease and risk factors in patients with spondyloarthritis: a real-life evidence from biostar nationwide registry

Duruöz,

Bodur,

Ataman

et al. 2024

Rheumatol Int

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The association between spondyloarthritis and cardiovascular (CV) diseases is complex with variable outcomes. This study aimed to assess the prevalence rates of CV diseases and to analyze the impact of CV risk factors on CV disease in patients with spondyloarthritis. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group’s prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461–6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631–7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189–28.810, p = 0.030) were the independent predictors for CV disease. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group’s prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461–6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631–7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189–28.810, p = 0.030) were the independent predictors for CV disease. The prevalence rate of CV disease was 3.0% in patients with spondyloarthritis. Hypertension, dyslipidemia, and cancer history were the independent CV risk factors for CV disease in patients with spondyloarthritis.

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“…In this regard, while several studies failed to demonstrate the association between inflammation and atherosclerosis, 9–12 a recent analysis of the Spanish multicentre AtheSpAin cohort found an independent association between baseline C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) with carotid intima-media thickness. 13 …”

Section: Introductionmentioning

confidence: 99%

Sex-specific impact of inflammation on traditional cardiovascular risk factors and atherosclerosis in axial spondyloarthritis. A multicentre study of 913 patients

Ferraz-Amaro,

Genre,

Blanco

et al. 2024

RMD Open

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IntroductionThe nature of the relationship between inflammation, cardiovascular (CV) risk factors and atherosclerosis in axial spondyloarthritis (axSpA) remains largely unknown and sex differences in this regard are yet to be assessed.MethodsStudy including 611 men and 302 women from the Spanish multicentre AtheSpAin cohort to assess CV disease in axSpA. Data on CV disease risk factors were collected both at disease diagnosis and at enrolment, and data on disease activity, functional indices and carotid ultrasonography only at enrolment.ResultsAfter a median disease duration of 9 years, patients of both sexes who at disease diagnosis had elevated acute phase reactants (APRs), more frequently had hypertension and obesity. The same occurred with dyslipidaemia in men and with diabetes mellitus in women. At enrolment, CV risk factors were independently associated with APR and with activity and functional indices, with various sex differences. C reactive protein (CRP) values were inversely associated with HDL-cholesterol in men (β coefficient: −1.2 (95% CI: −0.3 to −0.07) mg/dL, p=0.001), while erythrocyte sedimentation rate values were positively associated with triglycerides in women (β coefficient: 0.6 (95% CI: 0.04 to 1) mg/dL, p=0.035). Furthermore, only women showed an independent relationship between insulin resistance parameters and APR or disease activity. Both men and women with high–very high CV risk according to the Systematic Assessment of Coronary Risk Evaluation 2 and CRP levels higher than 3 mg/L at diagnosis of the disease presented carotid plaques significantly more frequently than those with normal CRP levels at disease diagnosis.ConclusionInflammation is associated with atherosclerosis and CV disease in axSpA. A gender-driven effect is observed in this relationship.

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Factors associated with atherosclerosis in radiographic and non-radiographic axial spondyloarthritis. A multicenter study on 838 patients

Cited by 8 publications

References 41 publications

Cardiovascular Disease and Cardiac Imaging in Inflammatory Arthritis

Cardiovascular Disease and Cardiac Imaging in Inflammatory Arthritis

Cross-sectional analysis of cardiovascular disease and risk factors in patients with spondyloarthritis: a real-life evidence from biostar nationwide registry

Sex-specific impact of inflammation on traditional cardiovascular risk factors and atherosclerosis in axial spondyloarthritis. A multicentre study of 913 patients

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