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Potential relation of cardiovascular risk factors to disease activity in patients with axial spondyloarthritis
Iván Ferraz-Amaro1, Javier Rueda-Gotor2, Fernanda Genre3
1Division of Rheumatology, Hospital Universitario de Canarias, Ofra sn, Tenerife, 38320, Spain.
Insights
Increased cardiovascular (CV) risk factors in axial spondyloarthritis (axSpA) patients are linked to higher disease activity. Managing CV risk factors may help control axSpA progression.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Background:
- Axial spondyloarthritis (axSpA) is associated with increased prevalence of comorbidities like atherosclerosis, hypertension, dyslipidemia, and diabetes.
- Understanding the link between traditional cardiovascular (CV) risk factors and disease characteristics in axSpA is crucial for patient management.
Purpose of the Study:
- To investigate the relationship between the number of traditional CV risk factors and disease characteristics, specifically disease activity, in patients with axSpA.
Main Methods:
- A cross-sectional study involving 804 axSpA patients.
- Assessment of five traditional CV risk factors: diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking status.
- Multivariable regression analysis to determine the independent association between CV risk factors and disease activity.
Main Results:
- Higher Ankylosing Spondylitis Disease Activity Score-C reactive protein (ASDAS-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were observed with an increasing number of CV risk factors.
- Patients with one or more CV risk factors showed significantly higher disease activity scores and odds of high disease activity compared to those with none.
- A dose-dependent effect was noted, with higher CV risk factor burden correlating with increased disease activity.
Conclusions:
- The number of traditional CV risk factors independently correlates with increased disease activity in axSpA patients.
- This suggests a potential therapeutic target for managing axSpA by addressing modifiable CV risk factors.
Background:
Axial spondyloarthritis (axSpA) patients are known to have a higher prevalence of several comorbidities, including, among others, an increased risk of atherosclerosis, hypertension, dyslipidemia, and diabetes. The purpose of the present study was to determine whether the sum of traditional cardiovascular (CV) risk factors is related to disease characteristics, such as disease activity, in patients with axSpA.
Methods:
A cross-sectional study that encompassed 804 patients with axSpA was conducted. Patients were assessed for the presence of five traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking status), and disease activity measurements. A multivariable regression analysis was performed to evaluate whether the number of classic CV risk factors was independently associated with specific features of the disease, to include disease activity.
Results:
A multivariable analysis showed that Ankylosing Spondylitis Disease Activity Score-C reactive protein (ASDAS-CRP) activity score was significantly higher in patients with 1 [beta coefficient 0.3 (95% confidence interval (CI) 0.1-0.5), p = 0.001] and ⩾2 [beta coefficient 0.5 (95% CI 0.3-0.7), p = 0.000] CV risk factors compared with those without CV risk factors. Similarly, patients with 1 [OR 2.00 (95%CI 0.99-4.02), p = 0.053] and ⩾2 [OR 3.39 (95%CI 1.82-6.31), p = 0.000] CV risk factors had a higher odds ratio for the presence of high disease activity compared with the zero CV category. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) activity score was significantly associated with the number of CV risk factors, being higher in patients with more CV risk factors. These relationships showed a CV risk factor-dependent effect being beta coefficients and ORs higher for the effect of ⩾2 over 1 CV risk factor.
Conclusion:
Among patients with axSpA, as the number of traditional CV risk factors increased, disease activity similarly increases in an independent manner.
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