Subclinical Atherosclerosis Is Not Accelerated in Patients with Ankylosing Spondylitis with Low Disease Activity: New Data and Metaanalysis of Published Studies

Arida, Aikaterini; Protogerou, Athanase D.; Konstantonis, George; Konsta, Maria; Delicha, Evi; Kitas, George D.; Sfikakis, Petros P.

doi:10.3899/jrheum.150316

Cited by 45 publications

(48 citation statements)

References 44 publications

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“…The authors suggested that subclinical atherosclerosis was not accelerated in patients with AS with low disease activity but reported that active AS was associated with an increase in carotid IMT values. 16 In the present study, the mean IMT of patients with AS whose BASDAI scores were 4 and above was substantially higher than the mean IMT of patients whose BASDAI scores were lower than 4.…”

Section: Discussioncontrasting

confidence: 57%

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Evaluation of subclinical atherosclerosis using ultrasound radiofrequency data technology in patients diagnosed with ankylosing spondylitis

Kaplanoğlu

2018

J of Ultrasound Medicine

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Section: Discussioncontrasting

confidence: 57%

“…The Clinical Trials Ethics Committee approved this study (Approval No. 16.01.17/34/23), and this study was conducted in accordance with the principles of the Declaration of Helsinki. Each participant provided a written informed consent.…”

Section: Study Group and Clinical Assessmentmentioning

confidence: 99%

Evaluation of subclinical atherosclerosis using ultrasound radiofrequency data technology in patients diagnosed with ankylosing spondylitis

Kaplanoğlu

2018

J of Ultrasound Medicine

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“…Basal flow was increased only in reference to TNFi treatment which may be attributed to a greater potency of this factor than disease activity itself. Reversibility of these microvascular changes with clinically effective therapies show that such improvement is aligned with the fact that low disease activity or TNFi therapy reduce inherent CVD risk 34 and atherosclerosis progression in AS 35,36 . Although LDF and PORH are considered valuable tools to study microcirculation function 16,33 , they have some disadvantages such as indirect blood flow measurement and lack of standardization.…”

Section: Discussionmentioning

confidence: 94%

Microvascular dysfunction in ankylosing spondylitis is associated with disease activity and is improved by anti-TNF treatment

Batko¹,

Maga

Urbański

et al. 2018

Sci Rep

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Ankylosing spondylitis (AS) is associated with high cardiovascular morbidity and mortality. Recent studies indicate that microvascular dysfunction may underlie cardiovascular risk in AS. We hypothesized, that microvascular morphology and dysfunction is linked to AS activity and is modifiable by TNF-α inhibitor (TNFi) treatment. Functional Laser Doppler Flowmetry with post-occlusive reactive hyperemia, and structural nailfold capillaroscopy were performed in 54 patients with AS and 28 matched controls. Active AS was diagnosed based on BASDAI ≥ 4 (n = 37). Effects of 3-month TNFi on microcirculation in active AS were studied. AS was associated with prolonged time to peak hyperemia compared to healthy controls. High disease activity was associated with increased time to peak hyperemia and decreased peak hyperemia when compared to patients with inactive AS. In capillaroscopy, AS was associated with morphological abnormalities indicating increased neoangiogenesis and pericapillary edema compared to controls. Microvascular function improved following 3 months of TNFi in reference to basal flow as well as post-occlusive parameters. TNFi reduced pericapillary edema, while other parameters of capillary morphology remained unchanged. Microvascular dysfunction and capillary neovascular formation are associated with disease activity of AS. Anti-TNF-α treatment may restore microcirculation function and capillary edema but does not modify microvascular structural parameters.

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“…Despite this expectation, inconsistent results have been achieved in clinical trials in patients with AS. Some have reported no difference between patients with AS and controls with respect to aortic stiffness as measured with PWV (13,14,24). On the other hand, Avram et al (25) reported higher PWV in patients with AS than those in controls, as well as an association between arterial stiffness and disease activity.…”

Section: Discussionmentioning

confidence: 99%

“…Of these biomarkers, carotid intima-media thickness (CIMT) and pulse wave velocity (PWV) have been suggested as independent risk factors for future CVD (5,6). However, inconsistent results have been reported regarding the value of CIMT and PWV in the detection of subclinical atherosclerotic CVD in patients with AS (7)(8)(9)(10)(11)(12)(13)(14)(15). In a recent meta-analysis, increased risk of subclinical atherosclerosis based on increased values of CIMT and PWV has been reported (16).…”

Section: Introductionmentioning

confidence: 99%

Assessment of subclinical atherosclerotic cardiovascular disease in patients with ankylosing spondylitis

et al. 2019

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Objective: The aim of the present study was to compare patients with ankylosing spondylitis (AS) with healthy controls with respect to subclinical atherosclerotic cardiovascular disease (CVD). Methods: A total of 44 patients with AS with no history of CVD, diabetes mellitus, hypertension, chronic kidney disease, and lipid-lowering drug use were compared with 40 age-and sex-matched healthy controls with respect to carotid intima-media thickness (CIMT) and pulse wave velocity (PWV), which are surrogate markers of subclinical atherosclerosis. Correlation analysis was also performed to examine the association between surrogate markers and disease activity with inflammation [Ankylosing spondylitis disease activity score with C-reactive protein (ASDAS-CRP)]. Results: In addition to age and sex, both groups were comparable with respect to cigarette smoking, body mass index, and high-density lipoprotein cholesterol (p=0.425, p=0.325, and p=0.103, respectively). The level of total cholesterol was significantly lower in patients with AS (p=0.002). Nonsteroidal anti-inflammatory drug and tumor necrosis factor alpha inhibitor use ratios in patients with AS were 79.5% and 65.9%, respectively. There was no significant difference between both groups regarding PWV and CIMT (p=0.788 and p=0.253, respectively). In patients with AS, there was a significant correlation between ASDAS-CRP and CIMT (r=0.315, p=0.038), but the correlation between ASDAS-CRP and PWV was not significant (r=−0.183, p=0.234). Conclusion:The results of the present study could not provide sufficient evidence whether disease activity with inflammation caused subclinical atherosclerotic CVD in patients with AS without overt CVD. The increased atherosclerotic CVD risk is most probably multifactorial in patients with AS, but the extent of the contribution of disease activity with inflammation to increased atherosclerosis is controversial. (Anatol J Cardiol 2019; 22: 185-91) ABSTRACT Hatipsoylu et al.

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Subclinical Atherosclerosis Is Not Accelerated in Patients with Ankylosing Spondylitis with Low Disease Activity: New Data and Metaanalysis of Published Studies

Abstract: Low AS disease activity is not associated with accelerated atherosclerosis.

Cited by 45 publications

References 44 publications

Evaluation of subclinical atherosclerosis using ultrasound radiofrequency data technology in patients diagnosed with ankylosing spondylitis

Evaluation of subclinical atherosclerosis using ultrasound radiofrequency data technology in patients diagnosed with ankylosing spondylitis

Microvascular dysfunction in ankylosing spondylitis is associated with disease activity and is improved by anti-TNF treatment

Assessment of subclinical atherosclerotic cardiovascular disease in patients with ankylosing spondylitis

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