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Carotid intima-media thickness in spondyloarthritis patients

Espessamento da camada média-íntima da carótida em pacientes com espondiloartrite

CONTEXT AND OBJECTIVE

Accelerated atherosclerosis has become a major problem in rheumatic inflammatory disease. The aim here was to analyze carotid intima-media thickness (IMT) in spondyloarthritis (SpA) patients and correlate this with clinical parameters and inflammatory markers.

DESIGN AND SETTING

Cross-sectional analytical study at Rheumatology Outpatient Clinic, Evangelical University Hospital, Curitiba.

METHODS

IMTs (measured using Doppler ultrasonography) of 36 SpA patients were compared with controls. The IMT in SpA patients was associated with inflammatory markers, like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); and with clinical parameters, like axial or peripheral involvement, dactylitis, HLA B27, uveitis occurrence, Bath Ankylosing Spondylitis Functional Index (BASFI) and lipid profile.

RESULTS

The mean IMT in SpA patients was 0.72 ± 0.21 mm; in controls, 0.57 ± 0.13 mm (P = 0.0007). There were no associations with ESR, CRP, BASDAI or clinical data. In univariate analysis, greater IMT was seen in patients with longer disease duration (P = 0.014; Pearson R = 0.40; 95% confidence interval, CI = 0.06 to 0.65); higher triglycerides (P = 0.02; Spearman R = 0.37; 95% CI = 0.03 to 0.64); and older age (P = 0.0014; Pearson R 0.51; 95% CI = 0.21 to 0.72).

CONCLUSION

SpA patients have a higher degree of subclinical atherosclerosis than in controls, thus supporting clinical evidence of increased cardiovascular risk in rheumatic patients.

Spondylarthropathies; Carotid artery diseases; Inflammation; Atherosclerosis; Spondylitis, ankylosing


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