Radiographic progression is associated with increased cardiovascular risk in patients with axial spondyloarthritis

Area of Science:

• Rheumatology
• Cardiology
• Epidemiology

Background:

• Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the spine.
• Patients with axSpA may have an increased risk of cardiovascular disease (CVD) due to chronic inflammation and shared risk factors.
• Understanding CVD risk in axSpA is crucial for early intervention and management.

Purpose of the Study:

• To compare the 10-year cardiovascular disease (CVD) risk between axial spondyloarthritis (axSpA) patients and matched controls.
• To identify specific factors, including disease activity and radiographic progression, associated with elevated CVD risk in axSpA patients.

Main Methods:

• A cross-sectional study involving 185 axSpA patients and 925 age- and sex-matched controls without prior CVD or diabetes.
• Assessment of traditional CVD risk factors and calculation of the 10-year CVD risk using the Framingham risk score (FRS).
• Evaluation of axSpA disease activity and radiographic progression (sacroiliitis, syndesmophytes) in the spine and sacroiliac joints.

Main Results:

• axSpA patients exhibited lower high-density lipoprotein (HDL) cholesterol and higher systolic blood pressure compared to controls.
• The mean 10-year Framingham risk score (FRS) was significantly higher in axSpA patients (6.3%) than in controls (5.0%).
• Radiographic progression, specifically the number of syndesmophytes and grade of sacroiliitis, correlated with the FRS, with syndesmophytes independently associated with higher CVD risk.

Conclusions:

• Axial spondyloarthritis patients demonstrate an elevated estimated 10-year cardiovascular disease risk compared to the general population.
• Spinal radiographic progression, particularly the development of syndesmophytes, is a significant independent predictor of increased CVD risk in axSpA.