title: Predictors of Atherosclerosis in Ankylosing Spondylitis.
abstract: OBJECTIVE
  Accelerated atherosclerosis associated with an enhanced inflammatory state, which characterizes ankylosing spondylitis (AS), is the leading cause of increased cardiovascular risk. The objective of this study was to assess carotid intima-media thickness (CIMT) as a surrogate for subclinical atherosclerosis in AS patients and its possible correlation with disease-related clinical parameters.
  
  
  METHODS
  We performed a prospective study of 30 consecutive patients meeting modified New York criteria for AS compared to 25 controls matched for age and sex. Patients with traditional CV risk factors were excluded. Disease-specific measures and inflammatory measures (ESR, CRP, TNF-α, IL-6 and IL-1) were determined. CIMT was measured in the right common carotid artery using high-resolution B-mode ultrasound.
  
  
  RESULTS
  AS patients exhibited increased CIMT compared to matched healthy controls (0.62 ± 0.12 vs. 0.53 ± 0.09 mm). CIMT was positively correlated with age, disease duration, disease activity (BASDAI and ASDAS) and the inflammatory measures ESR (r = 0.45, P = 0.11) and TNF-α (r = 0.62, P < 0.001). CIMT did not correlate with the BMI, BASFI, IL-6, IL-1 or cholesterol levels.
  
  
  CONCLUSIONS
  This study shows increased CIMT in AS patients without traditional cardiovascular risk factors compared to healthy controls. An increase in age, disease duration, disease activity (BASDAI and ASDAS), biomarkers of inflammation (ESR and CRP) and TNF-α may predict the occurrence of accelerated atherosclerosis in AS.
authors.affiliation: Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India.
authors.forename: Inderjeet
authors.initials: I
authors.lastname: Verma
authors.affiliation: Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India.
authors.forename: Pawan
authors.initials: P
authors.lastname: Krishan
authors.affiliation: Cardio Rheuma and Healing Touch City Clinic, Chandigarh and Rheumatologist Fortis Multi Specialty Hospital, Mohali, India. ashitsyngle@yahoo.com.
authors.forename: Ashit
authors.initials: A
authors.lastname: Syngle
keywords: Ankylosing spondylitis; Atherosclerosis; Carotid intima-media thickness; Inflammatory cytokines