Arterial Stiffness and Early Vascular Damage in Ankylosing Spondylitis Regardless of Cardiovascular Risk Factors: A...

Our aim is to evaluate subclinical vascular damage in patients with ankylosing spondylitis using one-point echo-tracking-derived arterial stiffness indices and carotid intima-media thickness (CIMT), and to explore associations with inflammatory activity and traditional cardiovascular risk scores.

This cross-sectional study included 83 patients with AS and 31 age- and sex-matched controls without inflammatory or cardiovascular disease. All participants underwent high-resolution ultrasound of the common carotid artery with one-point echo-tracking assessment of arterial stiffness parameters, including β-stiffness index, local pulse wave velocity (PWVβ), Peterson's elastic modulus (Ep), arterial compliance, and augmentation index, alongside CIMT measurement. Ten-year cardiovascular risk was estimated using the Framingham Risk Score and SCORE2.

Traditional cardiovascular risk estimates were comparable between groups (Framingham risk: 3.7 [2.0-7.5]% vs 5.25 [2.5-8.0]%, p = 0.378; SCORE2: 6.7 [3.5-10.5]% vs 7.3 [3.0-11.0]%, p = 0.718). In contrast, patients with AS demonstrated significantly increased arterial stiffness, with higher β-stiffness index (7.0 [5.4-8.6] vs 6.05 [5.2-6.9], p < 0.001), PWVβ (5.8 [5.2-6.5] vs 5.45 [4.9-5.9] m/s, p < 0.001), and Ep (90 [68-112] vs 78.5 [66-90] kPa, p < 0.001). CIMT did not differ significantly between groups. Body mass index independently predicted arterial stiffness (PWVβ standardized β = 0.41, p < 0.001).

Ankylosing spondylitis is characterised by early functional vascular impairment despite preserved traditional cardiovascular risk profiles. One-point echo-tracking-derived arterial stiffness indices identify subclinical vascular damage beyond conventional risk assessment and may improve cardiovascular risk stratification in AS.