Hyperlipoproteinemia (a) in Patients with Spondyloarthritis. Results of the CARMA Study

María Carmen García-Gómez¹, Maria Auxiliadora Martin², Cristina Fernández-Carballido³, Santos Castañeda⁴, Carlos González-Juanatey⁵, Fernando Sánchez-Alonso⁶, María José González-Fernández⁷, Raimon Sanmarti⁸, Alberto Garcia-Vadillo⁹, Benjamin Fernandez Gutierrez¹⁰, Miriam García-Arias¹¹, Javier Manero¹², José Miguel Senabre¹³, Amalia Rueda Cid¹⁴, Sergio Ros Expósito¹⁵, José Manuel Pina Salvador¹⁶, Alba Erra Durán¹⁷, Ingrid Moller¹⁸, Javier Llorca¹⁹ and Miguel Angel González-Gay²⁰, ¹Rheumatology Division, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain, ²Research Unit of Spanish Society of Rheumatology,, Madrid, Spain, ³Rheumatology Division, Hospital General Universitario de Elda, Elda, Spain, ⁴Rheumatology, Hospital La Princesa. Madrid. Spain, Madrid, Spain, ⁵Division of Cardiology, Hospital Universitario Lucus Augusti, Lugo, Spain, ⁶Unidad de Investigación, Spanish Society of Rheumatology, Madrid, Spain, ⁷Rheumatology, Institut Dexeus, Barcelona, Spain, ⁸Rheumatology Service, Hospital Clinic, Barcelona, Spain, ⁹Rheumatology, Hospital Universitario de La Princesa. IIS La Princesa, Madrid, Spain, ¹⁰Rheumatology Department, Hospital Clínico San Carlos, Madrid, Spain, ¹¹Hospital Universitario de la Princesa. Madrid. Spain, Madrid, Spain, ¹²Ophthalmology and Rheumatology, Hospital Miguel Servet. Zaragoza. Spain, Zaragoza, Spain, ¹³Rheumatology, Hospital Marina Baixa, Alicante, Spain, ¹⁴Rheumatology, Hospital General de Valencia, Valencia, Spain, ¹⁵Rheumatology, Hospital de Viladecans, Barcelona, Spain, ¹⁶Rheumatology, Hospital de Barbastro, Huesca, Spain, ¹⁷Rheumatology, Hospital de Sant Rafael, Barcelona, Spain, ¹⁸Instituto de Poal, Barcelona, Spain, ¹⁹Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Santander, Spain, ²⁰School of Medicine, University of Cantabria, Santander, Spain, Santander, Spain

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Ankylosing spondylitis (AS), Cardiovascular disease, Lipids, Psoriatic arthritis and spondylarthritis

Session Information

Date: Monday, October 22, 2018

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Clinical/Epidemiology Studies

Session Type: ACR Poster Session B

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

Background/Purpose: Cardiovascular disease (CVD) is one of the main cause of mortality and morbidity in patients with spondyloarthritis (SpA), partially explained by traditional CV risk factors (CVRF). Other non-conventional CVRF, probably related to chronic systemic inflammation, may be involved. In this sense, lipoprotein (a) [Lp (a)], an non-conventional risk factor with proatherogenic and thrombogenic properties, could be involved, since it seems to act as an acute-phase reactant, however, there are few data on this aspect in these patients. The purpose of this study is to evaluate the prevalence of hyperlipoproteinemia (a) in patients with SpA and analyze the possible related factors.

Methods: Analysis of the baseline visit of patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) of the CARMA project (CARdiovascular in Reumatology), a prospective cohort study of 10 years of follow-up, to evaluate the cardiovascular risk in chronic rheumatic inflammatory diseases, including rheumatoid arthritis, AS and PsA, followed in 67 Spanish rheumatology centers. A multivariate logistic regression model was performed, in which the dependent variable was hyperliproteinemia (a), defined as the plasma concentration of lipoprotein (a) [Lp (a)] > 50 mg/dl. Sociodemographic factors and those related to the disease itself, classic CVRF, lipid profile and apolipoproteins, and treatments have been included as independent variables.

Results: 1459 patients were analyzed, 738 with AS and 721 with PsA, and 677 controls. Plasma concentrations of Lp(a) were available in 57.7% of the patients with AS and in 57.1% of the patients with PsA, and in 58% of the controls. A 19.2% (95% CI: 16.80-22.05) of the patients with SpA, 20.7% (95% CI: 16.91-24.82) of AS and 17.7% (95% CI: 14.15-21.75) of PsA, respectively, and a 16.7% (95% CI: 13.23-20.86; p=0.326) of the control group, had hyperlipoproteinemia (a), without statistically significant differences between groups. After adjusting for age and sex, SpA patients were more likely to have hyperlipoproteinemia (a) than control group (OR : 1.43, CI:1.00-2.04; p=0.05), especially in patients with AS (OR: 1.81, 95% CI: 1.18-2.77; p=0.007).In the model adjusted for possible confounding factors, high values of apolipoprotein B in all patients, non-steroidal antiinflammatories in AS, and sex (women) in PsA, were associated with a higher probability of presenting hyperlipoproteinemia (a).

Conclusion: Patients with SpA show a moderately increased risk of hyperliproteinemia (a) compared to the control group, especially in those with AS. No specific factors of the disease have been identified that are associated with hyperlipoproteinemia (a) in each of the analyzed groups. The determination of Lp (a) may be of potential interest to improve the assessment of CV risk in patients with SpA, especially in those with a moderate / high CV risk according to the algorithms of the risk tables.

Disclosure: M. C. García-Gómez, None; M. A. Martin, None; C. Fernández-Carballido, None; S. Castañeda, None; C. González-Juanatey, None; F. Sánchez-Alonso, None; M. J. González-Fernández, None; R. Sanmarti, None; A. Garcia-Vadillo, None; B. Fernandez Gutierrez, None; M. García-Arias, None; J. Manero, None; J. M. Senabre, None; A. Rueda Cid, None; S. Ros Expósito, None; J. M. Pina Salvador, None; A. Erra Durán, None; I. Moller, None; J. Llorca, None; M. A. González-Gay, None.

To cite this abstract in AMA style:

García-Gómez MC, Martin MA, Fernández-Carballido C, Castañeda S, González-Juanatey C, Sánchez-Alonso F, González-Fernández MJ, Sanmarti R, Garcia-Vadillo A, Fernandez Gutierrez B, García-Arias M, Manero J, Senabre JM, Rueda Cid A, Ros Expósito S, Pina Salvador JM, Erra Durán A, Moller I, Llorca J, González-Gay MA. Hyperlipoproteinemia (a) in Patients with Spondyloarthritis. Results of the CARMA Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/hyperlipoproteinemia-a-in-patients-with-spondyloarthritis-results-of-the-carma-study/. Accessed .

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