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The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis

Ruocen Bai1, Yanfen Zhang1, Wen Liu1

  • 11 Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China.

Angiology
|December 1, 2018
PubMed

Insights

Patients with ankylosing spondylitis (AS) face a higher risk of subclinical atherosclerosis. This meta-analysis found increased carotid intima media thickness and pulse wave velocity, alongside decreased flow-mediated vasodilation in AS patients.

Area of Science:

  • Rheumatology and Cardiology
  • Vascular Biology
  • Epidemiology

Background:

  • Cardiovascular disease is the leading cause of mortality in ankylosing spondylitis (AS) patients.
  • Limited data exists on the association between AS and subclinical atherosclerosis.
  • The relationship between AS and early signs of atherosclerosis requires further investigation.

Purpose of the Study:

  • To assess the relationship between subclinical atherosclerosis and ankylosing spondylitis (AS) through a comprehensive meta-analysis.
  • To synthesize primary data from studies measuring flow-mediated vasodilation (FMD), carotid intima media thickness (cIMT), and pulse wave velocity (PWV) in AS patients.

Main Methods:

  • Systematic search of electronic databases for relevant studies.
  • Inclusion of 35 articles with 1535 AS patients and 1347 controls.
  • Statistical analysis including heterogeneity tests, publication bias assessment, sensitivity analysis, subgroup analysis, and meta-regression.

Main Results:

  • Patients with AS exhibited significantly increased carotid intima media thickness (cIMT) and pulse wave velocity (PWV).
  • A significant decrease in flow-mediated vasodilation (FMD) was observed in AS patients compared to controls.
  • No significant publication bias or statistical significance in sensitivity analysis was found.

Conclusions:

  • Ankylosing spondylitis patients have an elevated risk of developing subclinical atherosclerosis.
  • Early screening for subclinical atherosclerosis in AS patients is recommended.
  • Timely intervention strategies should be considered for AS patients to mitigate cardiovascular risk.

Keywords:
ankylosing spondylitisflow-mediated vasodilationintima media thicknessmeta-analysispulse wave velocitysubclinical atherosclerosis

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