Association Between Radiographic Progression and Cardiovascular Risk in Spondyloarthritis: Data from CoSpaR REGISTRY

María Lourdes Ladehesa-Pineda¹, Maria Carmen Castro ², Ignacio Gomez-Garcia ², Pedro Seguí-Azpilcueta ³, María del carmen ábalos-Aguilera ⁴, Rocío Segura-Ruiz ⁵, Rafaela Ortega ², Laura Bautista-Aguilar ⁶, Inmaculada Aranda-Varela ⁷, Clementina López-Medina ⁸, Juan Luis Garrido-Castro ⁹, Chary Lopez-Pedrera ², Alejandro Escudero-Contreras ⁷, Eduardo Collantes-Estévez ⁷ and Yolanda Jiménez-Gómez ⁴, ¹Universitary Hospital Reina Sofia of Cordoba/University of Cordoba/IMIBIC, Córdoba, Spain, ²IMIBIC/Reina Sofia Hospital/University of Cordoba, Cordoba, Spain, ³Universitary Hospital Reina Sofía of Córdoba, Córdoba, Spain, ⁴IMIBIC, Córdoba, Spain, ⁵Reina Sofia University Hospital/IMIBIC, Córdoba, Spain, ⁶[email protected], Córdoba, Spain, ⁷Universitary Hospital Reina Sofía of Córdoba/University of Córdoba/IMIBIC, Córdoba, Spain, ⁸Cochin Hospital, Rheumatology Department, Paris, France, ⁹University of Córdoba, Córdoba, Spain

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: axial spondyloarthritis, cardiovascular disease and radiography

Session Information

Date: Sunday, November 10, 2019

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster I: Axial Spondyloarthritis, Clinical Features

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Our objectives are:

To analyze the prevalence of comorbidities related to CV risk in a register of patients with spondyloarthritis (CoSpaR).
To evaluate if there is an association between structural damage, the presence of atherosclerotic plaques, the endothelial function and the increased CV risk in patients with axSpA.

Methods: Eight-five patients with axSpA from the SpA registry from Cordoba (CoSpaR) were selected for a cross-sectional study. Patients were recruited in a probabilistic and sequential way from a SpA monographic ambulatory, and a complete clinical history, physical examination and a biochemical analysis were performed.

CV risk was evaluated by estimating the SCORE index and assessing the presence of atherosclerotic plaques through carotid ultrasound. The study of endothelial function was performed with laser doppler flowmetry, analyzing the response to reactive hyperemia, so as the increase in blood flow occurred after temporary occlusion of blood flow.

Data was collected and analyzed using SPSS v25 program. Independent-samples t test was used to evaluate the association between radiological characteristics and presence of atherosclerotic plaques. The linear lelationship between the variables has been measured by Pearson’s linear correlation coefficient. Multiple lineal regression (MLR) was performed to assess the variables potentially associated with increased SCORE. All comparisons were bilateral considering p≤0.05 as a significant result.

Results: Baseline characteristics are shown in table 1.Characteristics related with radiographic damage and CV risk are shown in table 2. Direct linear relationship was found between the CV risk measured by SCORE index and total, lumbar and cervical mSASSS, and the presence of bone bridges. Analysis of atherosclerotic plaques at the carotid showed that age, disease duration, and variables related to radiographic damage (total mSASSS, cervical spine mSASSS, lumbar spine mSASSS, and bone bridges) were significantly higher in patients with atherosclerotic plaques(p< 0.05). In addition, mSASSS in cervical spine (p=0.063) and age (p< 0.0001) were found to be associated with the SCORE index value and were predictors of increased CV risk in MLR analysis. Endothelial function (measured by Laser Doppler measurement of post ischemic reactive hyperemia) correlated inversely (p< 0,05) with total and lumbar mSASSS, as shown by the values of hyperemic area after occlusion was released.

Conclusion: The presence of atherosclerotic plaques in patients with axSpA is associated not only with age and disease duration, but also with the degree of radiographic damage present. Age and structural damage predicted the increased risk of CV disease observed in axSpA. Therefore, we have observed that older patients with axSpA and more structural damage, especially in the cervical spine, had a greater risk of CV disease. Endothelial disfunction is also found in patients with axSpA.

Funded by: JA PI-0139-2017

Disclosure: M. Ladehesa-Pineda, None; M. Castro, None; I. Gomez-Garcia, None; P. Seguí-Azpilcueta, None; M. ábalos-Aguilera, None; R. Segura-Ruiz, None; R. Ortega, None; L. Bautista-Aguilar, None; I. Aranda-Varela, None; C. López-Medina, None; J. Garrido-Castro, None; C. Lopez-Pedrera, None; A. Escudero-Contreras, None; E. Collantes-Estévez, None; Y. Jiménez-Gómez, None.

To cite this abstract in AMA style:

Ladehesa-Pineda M, Castro M, Gomez-Garcia I, Seguí-Azpilcueta P, ábalos-Aguilera M, Segura-Ruiz R, Ortega R, Bautista-Aguilar L, Aranda-Varela I, López-Medina C, Garrido-Castro J, Lopez-Pedrera C, Escudero-Contreras A, Collantes-Estévez E, Jiménez-Gómez Y. Association Between Radiographic Progression and Cardiovascular Risk in Spondyloarthritis: Data from CoSpaR REGISTRY [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/association-between-radiographic-progression-and-cardiovascular-risk-in-spondyloarthritis-data-from-cospar-registry/. Accessed .

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