title: Assessment of preclinical atherosclerosis in patients with ankylosing spondylitis.
abstract: OBJECTIVE
  Epidemiological studies recently confirmed the increased risk of vascular morbidity and mortality during ankylosing spondylitis (AS). Increase of intima-media thickness (IMT) of the common carotid artery is a useful and noninvasive marker of preclinical atherosclerosis. The aim of our study was to compare IMT in patients with AS with matched controls and to determine risk factors of atherosclerosis related to AS.
  
  
  METHODS
  We performed a prospective study of 60 consecutive patients meeting modified New York criteria for AS, compared to 60 controls matched for age and sex. Disease-specific measures were determined. Measurement of IMT was performed by the same radiologist using the same machine and probe in right and left common carotid arteries, and the average of the 2 measurements was considered.
  
  
  RESULTS
  In total 48 male and 12 female patients were recruited, and 60 corresponding controls; mean age was 36 ± 11 years. We found significantly increased IMT in the AS group (0.51 ± 0.12 mm) compared with controls (0.39 ± 0.09 mm; p = 0.001). After adjustment for confounding factors, increased IMT was still present (p = 0.003). Age at onset of AS (p = 0.001), Bath AS Disease Activity Index (p = 0.002), AS Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR; p = 0.047), ASDAS C-reactive protein (CRP; p = 0.012), Bath AS Functional Index (p = 0.008), global spine visual analog scale for pain (p = 0.000), Schober index (p = 0.039), Bath AS Metrology Index (p = 0.028), modified Stoke Ankylosing Spondylitis Spine Score (p = 0.035), and high ESR (p = 0.001) and CRP (p = 0.000) were correlated with high IMT in patients with AS. Otherwise, status of arthritis (p = 0.442), enthesitis (p = 0.482), and HLA-B27 (p = 0.528) seemed to have no effect on IMT.
  
  
  CONCLUSIONS
  AS is associated with an increased risk of atherosclerosis independent of traditional risk factors. Disease activity, functional and mobility limitations, structural damage, and inflammation are the most incriminated risk factors.
authors.affiliation: Department of Rheumatology, Kassab Institute, Ksar Said, Manouba, Tunisia. wafahamdi6@yahoo.fr
authors.forename: Wafa
authors.initials: W
authors.lastname: Hamdi
authors.forename: Mouna
authors.initials: M
authors.lastname: Chelli Bouaziz
authors.forename: Imen
authors.initials: I
authors.lastname: Zouch
authors.forename: Mohamed Mehdi
authors.initials: MM
authors.lastname: Ghannouchi
authors.forename: Manel
authors.initials: M
authors.lastname: Haouel
authors.forename: Mohamed Fethi
authors.initials: MF
authors.lastname: Ladeb
authors.forename: Mohamed Montacer
authors.initials: MM
authors.lastname: Kchir
mesh_terms: D000328:Adult; D017668:Age of Onset; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D059168:Carotid Intima-Media Thickness; D005260:Female; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000453:epidemiology*
chemical_list: D015796:HLA-B27 Antigen; D002097:C-Reactive Protein