Disease Activity in Spondyloarthropathy: Does it affect Vascular Health?

Chronic inflammation in spondyloarthropathy (SpA) is associated with accelerated atherosclerotic cardiovascular disease (CVD). Flow mediated vasodilatation (FMD) and carotid intima-media thickness (cIMT) detects endothelial dysfunction and subclinical atherosclerosis respectively, responsible for atherosclerotic CVD.

We aimed to examine the association of disease activity in SpA with surrogate markers of CVD, i.e., FMD and cIMT.

Fifty patients of Axial SpA (Assessment of SpondyloArthritis Society-ASAS 2009 criteria) (<5 years disease duration) and 50 control subjects, matched for age (33.7±8.8 vs. 33.7±8.4 years) and sex, with no CV risk factors were recruited. Ultrasound assessment of FMD of brachial artery and cIMT of both common carotid arteries were performed. Measurements were compared between patients and controls by Student's t test. Association of disease activity in SpA patients with FMD and cIMT, were evaluated by Pearson/Spearman's correlation.

FMD (4.9±1.4 vs. 8.7±1.6 %) and cIMT (0.52±0.04 vs. 0.44±0.11 mm), were impaired in SpA patients than healthy controls (all p<0.05). However, subjects in both the groups had no difference in age and body mass index with similar, within normal range blood pressure and lipid profile.

We observed that FMD and cIMT were deranged in SpA, and higher disease activity in SpA was associated with impaired FMD and cIMT. However, a larger population with a prospective study-design would further confirm this relationship between SpA disease activity and CVD surrogate markers.