Carotid intima media thickness as a marker of atherosclerosis in ankylosing spondylitis
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Naveen Gupta1, Renu Saigal2, Laxmikant Goyal1
1Department of Medicine, SMS Medical College, Jaipur, India.
Insights
Patients with ankylosing spondylitis (AS) show increased carotid intima media thickness (CIMT), a marker of atherosclerosis. CIMT positively correlates with disease duration and specific disease activity scores, indicating a link between AS chronicity and cardiovascular risk.
Area of Science:
- Rheumatology
- Cardiology
- Medical Imaging
Background:
- Ankylosing spondylitis (AS) is associated with increased cardiovascular morbidity and mortality.
- Accelerated atherosclerosis is a suspected underlying mechanism for cardiovascular complications in AS patients.
Purpose of the Study:
- To evaluate carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in AS patients.
- To investigate the correlation between CIMT and disease activity/duration in AS.
Main Methods:
- A case-control study involving 37 AS patients and 37 matched controls.
- CIMT was measured using B-mode ultrasound.
- Disease activity was assessed using BASDAI, BASFI, BASMI, CRP, and ESR.
Main Results:
- AS patients exhibited significantly increased CIMT compared to controls (0.62 ± 0.12 vs. 0.54 ± 0.04, P < 0.001).
- CIMT positively correlated with age, disease duration, and BASMI in AS patients.
- CIMT showed a negative correlation with ESR levels in AS patients.
Conclusions:
- Patients with ankylosing spondylitis demonstrate higher CIMT, suggesting accelerated atherosclerosis.
- CIMT is significantly associated with disease chronicity and certain measures of disease activity in AS.
Abstract:
Aim. Increased cardiovascular morbidity and mortality have been observed in ankylosing spondylitis because of accelerated atherosclerosis. We measured carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in this study. Methods. In this study 37 cases of AS and the same number of matched individuals were recruited. CIMT measurements were done using B-mode ultrasound. Disease activity was assessed using Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. Results. Mean age of the study groups was 29.43 ± 9.00 years. Average disease duration was 65.62 ± 54.92 months. Twenty-eight (75.68%) of cases were HLA B-27 positive. A significantly increased CIMT was observed in cases as compared to control group (0.62 ± 0.12 versus 0.54 ± 0.04; P < 0.001). CIMT in the cases group positively correlated with age (r = 0.357; P < 0.05), duration of disease (r = 0.549; P < 0.01), and BASMI (r = 0.337; P < 0.05) and negatively correlated with ESR (r = -0.295; P < 0.05). Conclusions. Patients of AS had a higher CIMT than those of the control group. CIMT correlated with disease chronicity.
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