ENDOTHELIAL DYSFUNCTION AND CARDIOVASCULAR RISK IN PATIENTS WITH ANKYLOSING SPONDYLITIS

Abstract

Background. Ankylosing spondylitis is a disease that induces damage to the musculoskeletal system. Mortality rate among patients with AS is in 1.5 times higher than the population level. It is caused by cardiovascular disease and chronic renal failure.Objective. The research was aimed to study the prevalence of endothelial dysfunction and to establish its dependence on the factors of cardiovascular risk in patients with AS.Methods. 104 patients with ankylosing spondylitis (AS) were examined using standard diagnostic methods, such as disease activity, lipidogram, ultrasound of the carotid artery intima media, and endothelium vasodilatation in response to reactive hyperaemia was evaluated. Clinical activity of the disease was determined using the disease activity index BASDAI, BASFI functional index, index BASMI metrology, ASQoL quality of life. To estimate the 10-year risk of cardiovascular disease, the QRISK scale was used.Results. Endothelial dysfunction (ED) was found in 47% cases. It was established that in the patients with ED<10% the incidence of LPL>1.7 mg/L, HDL-C<1.0 mmol/L, TIM thickening>0.9 mm was higher than in the patients with ED>10%. In this group of patients, significant duration of the disease and essential differences in their progress in terms of VAS, CRP, ESR, index activity and functional disorders were revealed.Conclusions. The problem of CVD in patients with AS may be caused by systemic inflammatory disease associated with the development of endothelial dysfunction and increased levels of atherogenic lipids.