Disease-related factors associated to atherosclerotic disease in axial spondyloarthritis. A mutlicenter study with 806 patients. - ACR Meeting Abstracts

Abstract Number: 0448

Disease-related factors associated to atherosclerotic disease in axial spondyloarthritis. A mutlicenter study with 806 patients.

Inigo Gonzalez-Mazon¹, Ivan Ferraz-Amaro², Javier Rueda-Gotor³, Lara Sanchez-Bilbao⁴, David Martinez-Lopez⁵, Mario Agudo-Bilbao³, Fernanda Genre⁶, Sara Remuzgo-Martínez⁶, Veronica Pulito-Cueto⁶, Alfonso Corrales⁷, Leticia Lera-Gómez⁶, Virginia Portilla⁶, Vanesa Calvo-Río³, Cristina Mata⁸, Vanesa Hernández-Hernández⁹, Santos Castañeda¹⁰, Esther Francisca Vicente-Rabaneda¹¹, C Fernandez-Carballido¹², M Paz Martínez-Vidal¹³, David Castro-Corredor¹⁴, Joaquín Anino-Fernández¹⁴, Juan Carlos Quevedo-Abeledo¹⁵, Carlos Rodríguez-Lozano¹⁶, C. Fernandez-Diaz¹⁷, Esther Montes-Perez¹⁸, María Luz García Vivar,¹⁹, Eva Galínez-Agirregoikoa¹⁹, Javier Llorca²⁰, Raquel López-Mejías⁶, Chamaida Plasencia²¹, Diana Peiteado²², Alejandro Balsa-Criado²³, Nuria Barbarroja²⁴, Lourdes Ladehesa-Pineda²⁵, Rafaela Ortega-Castro²⁶, Eduardo Collantes-Estévez²⁵, Ricardo Blanco⁴ and Miguel Ángel González-Gay²⁷, ¹Hospital Universitario Marques de Valdecilla, Bezana, Spain, ²Division of Rheumatology. Hospital Universitario de Canarias. Spain., Santa Cruz de Tenerife, Spain, ³H.U. Marques de Valdecilla, Santander, Spain, ⁴Hospital Universitario Marques de Valdecilla, Santander, Spain, ⁵Hospital Universitario Marques de Valdecilla, Santander (SPAIN), Spain, ⁶Research group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic bone Diseases of the Musculoskeletal System, IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain, ⁷Research group on genetic epidemiology and atherosclerosis in systemic diseases and in metabolic bone diseases of the musculoskeletal system, IDIVAL; and Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain, ⁸Hospital de Laredo, Santander, Spain, ⁹Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain, ¹⁰Princesa University Hospital, Universidad Autónoma, Madrid, Madrid, Spain, ¹¹Hospital Universitario de la Princesa, IIS-Princesa, UAM, Madrid, Madrid, Spain, ¹²H San Juan, Alicante, Spain, ¹³Hospital General Universitario de Alicante, Alicante, Spain, ¹⁴Hospital General Universitario de Ciudad Real, Ciudad Real, Spain, ¹⁵Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain, ¹⁶Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain, ¹⁷H. Marqués de Valdecilla, Madrid, Spain, ¹⁸Diagnóstico Médico Cantabria (DMC), Santander, Spain, ¹⁹Hospital Universitario Basurto, Bilbao, Spain, ²⁰School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain, ²¹Rheumatology, La Paz University Hospital-IdiPAZ, madrid, Spain, ²²Hospital Universitario La Paz-IdiPaz, Madrid, Spain, ²³HOSPITAL UNIVERSITARIO LA PAZ, madrid, Spain, ²⁴Rheumatology Department, Reina Sofia University Hospital/ Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/ University of Cordoba, Cordoba, Spain, Cordoba, Spain, ²⁵Rheumatology Department, Reina Sofia University Hospital/ Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/ University of Cordoba, Cordoba, Spain, Córdoba, Spain, ²⁶Hospital Universitario Reina Sofía, Córdoba, Spain, ²⁷Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain

Meeting: ACR Convergence 2020

Keywords: Ankylosing spondylitis (AS), Cardiovascular, Carotid Artery Disease, risk factors, spondyloarthritis

Session Information

Date: Friday, November 6, 2020

Session Title: Imaging of Rheumatic Diseases (0444–0448)

Session Type: Abstract Session

Session Time: 10:00AM-10:50AM

Background/Purpose: Cardiovascular (CV) mortality and morbidity is increased in ankylosing spondylitits (AS) due to a process of accelerated atherosclerosis. The disease-related factors involved in this process are not yet well known. The aim of this study is to identify factors associated with subclinical atherosclerosis in the largest series of axial spondyloarthritis (axSpA) studied so far, and to analyze possible differences in this regard between AS and non-radiographic axial spondyloarthritis (nr-axSpA).

Methods: This is a transversal observational study from the AtheSpAin cohort, a Spanish multicenter cohort to study atherosclerosis in axSpA. We included patients older than 18 years old diagnosed with axSpA according to ASAS criteria. Carotid ultrasound (US) examination was done in all patients, included the measurement of carotid intima-media wall thickness (cIMT) in the common carotid artery and the detection of plaques in the extracranial carotid tree bilaterally, according to the Mannhein consensus.

Results: 639 AS patients and 167 nr-axSpA were recruited. Baseline characteristics and clinical features are shown in table 1

Table 2 shows the association between three surrogate markers for subclinical atherosclerosis (unilateral and bilateral carotid plaques and cIMT) with disease features, analyzed in an unadjusted model. As expected, cardiovascular risk factors (CRF) were associated with the presence of carotid plaques and cIMT.

Concerning disease related data, a very high disease activity according to ASDAS-CPR was related with both unilateral and bilateral plaques as well as an increased cIMT. BASDAI was associated only with cIMT. The three surrogate markers for atherosclerosis were also associated with CPR and ESR at time of diagnosis. The severity of the disease measured by BASMI, BASFI or hip involvement and the radiographic damage were strongly associated with subclinical atherosclerosis. History of synovitis and extraarticular manifestations as well as the use of prednisone and DMARDs were found to be related with IMT.

After adjustment for age, sex and CRF, associations with surrogate markers for atherosclerosis remained statistically significant for BASFI (unilateral plaques: OR 1.13, p=0.01), BASMI (bilateral plaques: OR 1.22, p=0.01), use of prednisone and DMARDs (bilateral plaques: OR 2.42, p=0.03; OR 2.10, p=0.02 respectively), CRP and ESR at time of diagnosis (IMT: beta coefficient 0,31, p=0,047 and 0.77, p=0,002 respectively), and inflammatory bowel disease (bilateral plaques: OR 3.48, p=0.01).

Differences, between AS and nr-axSpA, in the effect of CV riks factors on cIMT/carotid plaque were assessed including interaction factors in the regression models. In this sense, no differences were found between both subtypes of patients in the effects of CV risks factors over CIMT/carotid plaque.

Conclusion: Apart from CRF, the atherosclerotic disease in axSpA is associated with disease-related factors such as the inflammatory response, the severity of the disease or extraarticular manifestations, without differences between AS and nr-axSpA.

Disclosure: I. Gonzalez-Mazon, None; I. Ferraz-Amaro, None; J. Rueda-Gotor, None; L. Sanchez-Bilbao, None; D. Martinez-Lopez, Lilly, 2; M. Agudo-Bilbao, None; F. Genre, None; S. Remuzgo-Martínez, None; V. Pulito-Cueto, None; A. Corrales, None; L. Lera-Gómez, None; V. Portilla, None; V. Calvo-Río, None; C. Mata, None; V. Hernández-Hernández, None; S. Castañeda, Roche, 2; E. Vicente-Rabaneda, Roche, 8, BMS, 2, 8; C. Fernandez-Carballido, None; M. Martínez-Vidal, None; D. Castro-Corredor, None; J. Anino-Fernández, None; J. Quevedo-Abeledo, None; C. Rodríguez-Lozano, None; C. Fernandez-Diaz, None; E. Montes-Perez, None; M. García Vivar,, None; E. Galínez-Agirregoikoa, None; J. Llorca, None; R. López-Mejías, None; C. Plasencia, None; D. Peiteado, None; A. Balsa-Criado, None; N. Barbarroja, None; L. Ladehesa-Pineda, None; R. Ortega-Castro, None; E. Collantes-Estévez, None; R. Blanco, None; M. González-Gay, None.

To cite this abstract in AMA style:

Gonzalez-Mazon I, Ferraz-Amaro I, Rueda-Gotor J, Sanchez-Bilbao L, Martinez-Lopez D, Agudo-Bilbao M, Genre F, Remuzgo-Martínez S, Pulito-Cueto V, Corrales A, Lera-Gómez L, Portilla V, Calvo-Río V, Mata C, Hernández-Hernández V, Castañeda S, Vicente-Rabaneda E, Fernandez-Carballido C, Martínez-Vidal M, Castro-Corredor D, Anino-Fernández J, Quevedo-Abeledo J, Rodríguez-Lozano C, Fernandez-Diaz C, Montes-Perez E, García Vivar, M, Galínez-Agirregoikoa E, Llorca J, López-Mejías R, Plasencia C, Peiteado D, Balsa-Criado A, Barbarroja N, Ladehesa-Pineda L, Ortega-Castro R, Collantes-Estévez E, Blanco R, González-Gay M. Disease-related factors associated to atherosclerotic disease in axial spondyloarthritis. A mutlicenter study with 806 patients. [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/disease-related-factors-associated-to-atherosclerotic-disease-in-axial-spondyloarthritis-a-mutlicenter-study-with-806-patients/. Accessed January 23, 2022.

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