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Cardiovascular and disease-related features associated with extra-articular manifestations in axial spondyloarthritis. A multicenter study of 888 patients

Abstract: Objectives: To determine the potential impact of extra-articular manifestations (EAMs) on disease characteristics and cardiovascular (CV) risk in patients with axial spondylarthritis (axSpA). Methods: This is a cross-sectional study from the AtheSpAin cohort, a Spanish multicenter cohort to study atherosclerosis in axSpA. Data on the history of CV events, subclinical carotid atherosclerosis, and disease-related features, including EAMs, were collected. Results: 888 axSpA patients were recruited. Concomitant acute anterior uveitis (AAU), psoriasis (PSO), and inflammatory bowel disease (IBD) were present in 177 (19.9%), 96 (10.8%), and 57 (6.4%) patients, respectively. When compared with axSpA patients without EAMs, a significant increase in past CV events was observed in patients with PSO (9% versus 4%, p = 0.048) and in those with at least one EAM (7% versus 4%, p = 0.032) or with more than one EAM (11% versus 4%, p = 0.022). The frequency of carotid plaques and the values of cIMT were higher in patients with EAMs than in those without EAMs, although only the univariable analysis for carotid plaques in patients with PSO (39% versus 30%, p = 0.038) and for cIMT in patients with AAU (665 ± 156 µm versus 637 ± 139 µm, p = 0.042) and those with at least one EAM (661 ± 155 µm versus 637 ± 139 µm, p = 0.024) showed significant results. In addition, patients with PSO or IBD were found to have specific disease-related features, such as higher ESR at diagnosis, and more frequent use of glucocorticoids and TNF inhibitors than those without EAMs. Also, PSO patients had more commonly peripheral involvement and those with AAU more severe radiographic damage than those without EAMs. The frequency of HLA B27 was higher in patients with AAU and lower in those with PSO or IBD compared to those without EAMs. Conclusion: Patients with axSpA and EAMs, in addition to displaying their own disease-related features, are likely to have an increased CV risk that appears proportional to the number of EAMs and could be related to proatherogenic factors other than traditional CV risk factors, such as the inflammatory load and the use of glucocorticoids.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Semin Arthritis Rheum Volume 57, December 2022, 152096

Editorial: Elsevier

 Año de publicación: 2022

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.semarthrit.2022.152096

ISSN: 0049-0172,1532-866X

Url de la publicación: https://doi.org/10.1016/j.semarthrit.2022.152096

Autores/as

JAVIER RUEDA GOTOR

FERRAZ-AMARO, IVÁN

GENRE, FERNANDA

GONZÁLEZ MAZÓN, IÑIGO

CORRALES, ALFONSO

PORTILLA, VIRGINIA

AGUDO-BILBAO, MARIO

AURRECOECHEA, ELENA

EXPÓSITO, ROSA

HERNÁNDEZ-HERNÁNDEZ, VANESA

QUEVEDO-ABELEDO, JUAN CARLOS

RODRÍGUEZ-LOZANO, CARLOS

LOPEZ-MEDINA, CLEMENTINA

LADEHESA-PINEDA, MARÍA LOURDES

CASTAÑEDA, SANTOS

VICENTE, ESTHER F

FERNÁNDEZ-CARBALLIDO, CRISTINA

MARTÍNEZ-VIDAL, M PAZ