title: Atherosclerotic disease in axial spondyloarthritis: increased frequency of carotid plaques.
abstract: OBJECTIVE
  To establish whether subclinical atherosclerosis is increased in patients with axial spondyloarthritis (ax-SpA).
  
  
  METHODS
  A set of 149 consecutive patients with no history of cardiovascular disease that fulfilled the Assessment of SpondyloArthritis International Society classification criteria for ax-SpA was studied by carotid ultrasonography. Carotid intima-media thickness (cIMT) and plaques were assessed. A series of 181 community-based controls with no cardiovascular disease were studied for comparison. To establish whether ax-SpA might have a direct effect on the risk of carotid plaques or an indirect effect via its putative influence on hypertension, dyslipidaemia or obesity, we obtained adjusted odds ratios (OR) for each clinical factor by the development of adjusted models.
  
  
  RESULTS
  cIMT was increased in patients (0.621±0.123 mm) when compared to controls (0.607±0.117 mm) but the difference was not significant (p=0.30). Nevertheless, carotid plaques were more commonly observed in patients with ax-SpA than in controls (41.6% vs. 26.4%; p=0.003). Patients with plaques had longer duration of the disease than those without plaques (20.5±11.2 years vs. 12.0±8.6 years; p<0.001). Plaques were more frequent in patients with hip involvement (crude odds ratio 3.15, 95% confidence interval [CI] 1.02-9.75; p=0.05), syndesmophytes (crude OR 4.94, 95% CI 2.14-11.4; p<0.001), in patients with higher functional limitation and mobility index measured by BASFI (crude OR 1.16, 95% CI 1.02-1.33; p=0.03) and BASMI (crude OR 1.45, 95% CI 1.19-1.77; p<0.001), and in those with psoriasis (crude OR 3.94, 95% CI 1.31-11.84; p=0.02. However, except for psoriasis that continued being a strong risk factor for plaques after adjustment, the relationship between other clinical features of ax-SpA and carotid plaques disappeared in the adjusted models.
  
  
  CONCLUSIONS
  Our results confirm the presence of subclinical atherosclerosis in patients with ax-SpA.
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Rueda-Gotor
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Corrales
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Blanco
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Fuentevilla
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Portilla
authors.affiliation: Division of Rheumatology, Hospital Comarcal, Laredo, Cantabria, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Expósito
authors.affiliation: Division of Rheumatology, Hospital Comarcal, Laredo, Cantabria, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Mata
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain.
authors.forename: Trinitario
authors.initials: T
authors.lastname: Pina
authors.affiliation: Division of Cardiology, Hospital Lucus Augusti, Lugo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: González-Juanatey
authors.affiliation: Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Santander, and CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Llorca
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, and Cardiovascular Pathophysiology and Genomics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D025241:Spondylarthritis / Q000175:diagnosis / Q000453:epidemiology*