Impact of traditional and ankylosing spondylitisassociated risk factors on the formation of atherosclerotic lesions in the brachiocephalic arteries

Abstract

Introduction. Ankylosing spondylitis (AS) is associated with an increased risk of cardiovascular diseases (CVD). Well-known cardiovascular risk scales underestimate the possibility of the onset of cardiovascular complications and do not take into account the peculiarities of inflammatory rheumatic diseases. To improve risk stratification and timely prevention, it is necessary to study the risk factors associated with damage to the cardiovascular system in AS. Objective. To study the risk factors associated with carotid atherosclerotic lesions in ankylosing spondylitis. Material and Methods. The study included 32 male patients with AS who underwent a general clinical examination. In these patients, traditional factors of cardiovascular risk were identified; the activity and functional status of the disease were determined. To identify atherosclerotic lesions of the carotid arteries, Doppler ultrasound was used to measure carotid intima-media thickness and to identify atherosclerotic plaques. Results. The carotid intima-media thickness (CIMT) in the group was 0.9 mm [0.7; 1.2]; the median age was 38.2 years [32.0; 43.5]. With the application of age and sex norms, an increase in CIMT was observed in 80.6% of patients. The correlation analysis of the structure of traditional risk factors demonstrated the significant associations of CIMT with age ( r = 0.609, р < 0.0001), body mass index ( r = 0.439, p = 0.013), glucose level ( r = 0.528, p = 0.002), triglycerides ( r = 0.458, p = 0.010), and total cholesterol ( r = 0.398, p = 0.027). High rates of smoking (6 out of 16 against 14 out of 16, χ 2 = 7.888, p = 0.009) and arterial hypertension (4 out of 16 against 10 out of 16, χ 2 = 7.630, p = 0.009) were found mostly in the group with increased CIMT. No significant differences and relationships of CIMT with disease activity indicators and antirheumatic therapy were revealed. Significant relationships were found between the atherosclerotic lesions of the carotid arteries in patients with AS with the duration of the disease ( r = 0.370, p = 0.041) and functional status assessed using the BASFI index ( r = 0.507, p = 0.004). Conclusions . The study revealed a high prevalence of traditional cardiovascular risk factors among patients with AS, as well as the significant associations of the duration of the disease and the degree of functional impairment with the formation of carotid atherosclerotic lesions. The results of the study suggest that a more thorough assessment of CVD risk, as well as the use of additional objective criteria, are necessary for patients with AS.