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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

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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 June 29, 2022.
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