Background ankylosing spondylitis (AS), like the other chronic inflammatory rheumatic diseases, is considered to have higher cardiovascular (CV) risk (1). The Etiopathogenesis is not clearly defined.
Objectives assess the early biological markers of atherosclerosis in Tunisian patients with AS compared with healthy controls and evaluate the relationship between Systematic Coronary Risk Evaluation (SCORE) for CV-related mortality and biological markers (2).
Methods This was a cross-sectional study conducted since June 2015 until October 2016 including patients with AS in the South of Tunisia and matched controls with sex, age, body mass index (BMI) and smoking. Patients diagnosed with AS should fulfill the modified New York criteria. For patients and controls, we measured total cholesterol (TC), high density lipoprotein (HDL) cholesterol, triglycerides, apolipoprotein (Apo) AI, ApoB, lipoprotein (a) [Lp(a)] and C-Reactive Protein (CRP). Low-density lipoprotein (LDL) cholesterol was calculated with the Friedewald formula. SCORE was calculated through the use of sex, age, systolic pressure, smoking and TC. Comparisons were performed using two sample t-tests for parametric values and Wilcoxon Mann-Whitney Test for non-parametric values. Correlation analyses were performed with Spearman rank.
Results Overall 79 patients with AS and 79 controls were included. The mean age was (43.81±14.29 vs 44,27±14 years). The sex ratio (M/F) was 2/1 and the mean BMI was (25.9±5.3 vs 25.76±3.5 kg/m2). AS patients had significantly lower levels of HDL and TC and a higher level of CRP and atherogenic index (TC/HDL, ApoB/ApoA). AS patients had higher CV mortality than controls (1.1±1.8 vs 0,51±1.13%, p=0.01). The frequency of high cardiovascular risk was higher in AS patients (5 vs 2, p=0.4). The correlation between SCORE's risk and biological markers were positive with TC, LDL, Lp (a), TC/HDL ratio and LDL/HDL ratio.
Conclusions AS patients are at a greater cardiovascular risk due to a higher CRP rate, atherogenic index and 10-year risk SCOREs of CV mortality. So, the dyslipidaemia and inflammation could be the aetiology of cardiovascular risk.
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Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003 Jun;24(11):987–1003.
Disclosure of Interest None declared