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Du-Moxibustion in a Mouse Model of Ankylosing Spondylitis

Du-Moxibustion in a Mouse Model of Ankylosing Spondylitis

Published on: October 27, 2023

[Routine and new risk factors for cardiovascular diseases in patients with ankylosing spondylitis (Bechterev's

D A Poddubnyĭ, A P Rebrov

Terapevticheskii Arkhiv

|August 4, 2007

Insights

Ankylosing spondylitis (AS) patients face a higher cardiovascular disease (CVD) death risk due to factors beyond conventional risk assessment. New indicators like elevated prothrombotic factors and left ventricular hypertrophy (LVH) are crucial for accurate CVD risk stratification in AS.

Area of Science:

Rheumatology
Cardiology
Internal Medicine

Context:

Ankylosing spondylitis (AS) is a chronic inflammatory disease.
Cardiovascular diseases (CVD) are a significant concern in AS patients.
Conventional risk factors may not fully capture CVD risk in AS.

Purpose:

To analyze standard and novel risk factors for CVD development in AS patients.
To assess the prevalence of CVD and its risk factors in AS.
To identify additional risk factors contributing to CVD in AS.

Summary:

AS patients showed similar prevalence of arterial hypertension and ischemic heart disease as the general population.
While conventional CVD risk scores were comparable, AS patients exhibited increased prothrombotic factors and frequent left ventricular hypertrophy (LVH).
Elevated fibrinogen, von Willebrand factor, platelets, and reduced fibrinolytic activity contribute to a higher thrombosis risk.

Impact:

Identifies limitations of conventional CVD risk stratification in AS.
Highlights the importance of assessing novel risk factors in AS management.
Suggests that unidentified risk factors contribute to increased CVD mortality in AS patients.

Read full analysis

Abstract

Aim:

Analysis of standard and new risk factors (RF) to develop cardiovascular diseases (CVD) in patients with ankylosing spondylitis (AS).

Material And Methods:

Examination of 96 patients with a documented diagnosis of AS has detected symptoms of CVD (arterial hypertension--AH, ischemic heart disease -IHD) and conventional CVD RF (smoking, hyper- and dyslipidemia, overweight, hereditary predisposition, diabetes mellitus). The SCORE scale assessed the risk of CVD complications within 10 years of ischemic heart disease. The following RF were also studied: the levels of C-reactive protein, fibrinogen, platelets, von Willebrand factor activity, total fibrinolytic plasma activity, left ventricular hypertrophy (LVH) according to echocardiography, intima-media complex thickness of the common carotid artery by USI.

Results:

Prevalence of AH in the examinees (34.4%), IHD (4.2%) was within population values. Total risk for IHD calculated with consideration of conventional RF in AS patients (6.3 +/- 5.0%) did not differ much from mean populational (6.8 +/- 4.4%) while in the absence of hypertension it was lower (4.1 +/- 2.5 and 5.4 +/- 3.5%, respectively, p < 0.05). The risk for lethal CVD complications proved not high (1.46 +/- 1.34%). However, AS patients have high risk for thrombosis due to elevated levels of prothrombogenic factors (fibrinogen, von Willebrand factor, platelets) and subnormal fibrinolytic blood activity. AS patients also demonstrate frequent LVH (overall 51% and 42.9% in normotensive AS patients).

Conclusion:

Higher risk of CVD death in AS patients than in general population may be caused by additional RF missed at conventional stratification.

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