Background Cardiovascular events are the leading cause of mortality in arthritis. However, data of cardiovascular (CV) morbidity and mortality in spondyloarthritis (SpA) are contradictory. Current data about CV mortality and morbidity in SpA in Russian population are limited.
Objectives The aim of the study was to evaluate CV morbidity and mortality in patients with SpA.
Methods 676 patients with SpA without CV diseases were involved, 160 healthy individuals included as controls. In 10 years of follow-up CV events (cardiac death, angina, myocardial infarction (MI), stroke, arterial hypertension (AH), arrhythmias or conduction disturbances) were recorded. Statistical analysis was performed using SPSS17.
Results 313 patients and 10 controls had loss the follow-up. From 363 patients with 10-year results 278 had axial SpA (axSpA), 85 – psoriatic arthritis (PsA)). Mean age±SD was 40.1±14.1 years in SpA, 40.0±11.4 in axSpA, 40.55±10.6 in PsA, 39.0±11.2 in controls, p≥0.05 for all. Prevalence of male was recorded in axSpA compared with PsA (p=0.02), other groups were matched in gender, p≥0.05 (69.7% males in SpA, 76.3% in axSpA, 48.2% in PsA, and 56% in controls). Smoking was frequently occurred in axSpA (68%, p<0.05 with all the other groups). Frequency of CV events is presented in table.
Arrhythmias were recorded in 55 (15.2%), conduction disorders – in 48 (13.22%), stroke – in 9 (2.47%) SpA patients.
Odds ratio (OR) of death in SpA as compared to controls was 4.6 (95% confidential interval (CI) 0.4–10.6), p>0.05, in PsA OR=8.0 (CI 5.7–16.1) compared to controls and 9.9 (CI 6.0–18.1), compared to axSpA, p<0.0001 for all, image.
Relative risk (RR) of MI in axSpA was 1.77 (CI 1.5–2.1), in PsA – 4.3 (CI 2.5–14.5), compared to controls, p<0.0001 for all. In controls risk of MI was comparable with expected population level (RR 1.24, CI 0.96–1.59).
In axSpA RR for AH = 2.23 (CI 1.6–3.1), in PsA RR = 3.09 (CI 2.19–4.35), p<0.0001 compared to controls.
Conclusions CV mortality in SpA and axSpA is comparable to population level, in PsA is higher, than in healthy controls and in ax-SpA. The incidence of angina, MI, AH in patients with ax-SpA and PsA exceeds the incidence in healthy controls.
Disclosure of Interest None declared