ACCELERATED ATHEROSCLEROSIS IN ANKYLOSING SPONDYLITIS

Background: Preliminary evidence suggests that ankylosing spondylitis (AS) is associated with an increased cardiovascular (CV) risk, but evidence is sparse and, if present, outdated. Objectives: We investigated subclinical atherosclerosis and arterial stiffness in patients with AS compared with control subjects, and identified CV and AS related risk factors for atherosclerotic disease. Methods: 59 AS patients, who were scheduled for etanercept treatment according to the ASAS guidelines, and 30 healthy controls were recruited. Subclinical atherosclerosis was assessed as the average intima-media thickness (IMT) of the common carotid artery. Brachial pulse pressure was calculated as systolic minus diastolic blood pressure and the carotid pulse pressure was determined according to the method from van Bortel and coworkers [1]. Arterial stiffness was estimated by distensibility, compliance and Young's elastic modulus of the carotid artery. Results: AS patients had a greater intima media thickness (0.62±0.09 mm versus 0.57±0.09 mm, p = 0.02). In addition, AS was associated with a higher brachial and carotid pulse pressure (i.e. 51±6 mmHg versus 46±7 mmHg, p = 0.02 and 47±7 mmHg versus 44±8 mmHg, p = 0.04, respectively), but this was not reflected by impaired arterial stiffness indices. Differences remained after adjustment for cardiovascular risk factors. Among AS patients, age and body mass index correlated with IMT. Age, body mass index, total cholesterol, triglycerides and disease duration correlated with all stiffness indices. Conclusion: This study is the first to demonstrate that AS is associated with subclinical atherosclerosis and an increased brachial and carotid pulse pressure. These differences were not attributable to CV risk factors, suggesting that AS should be regarded as independent atherosclerotic risk factor. References: 1. Van Bortel LM, Balkestein EJ, van der Heijden-Spek JJ, et al. Non-invasive assessment of local arterial pulse pressure: comparison of applanation tonometry and echo-tracking. J.Hypertens. 2001;19:1037-1044 Disclosure of Interest: none declaredCitation: Annals of the Rheumatic Diseases, volume 68, supplement 3, year 2009, page 159Session: Ultrasonography across the rheumatic diseases (Oral Presentations )