Patients With Nonradiographic Axial Spondyloarthritis at High Risk of CVD, Model Predicts

Some 45.5% of patients with non-radiographic axial spondyloarthritis (nr-axSpA) deemed at moderate risk of cardiovascular disease per the Systematic COronary Risk Evaluation (SCORE) model were reclassified as very high risk after ultrasound imaging revealed carotid plaques, according to a study published in Seminars in Arthritis and Rheumatism. 

Researchers noted that “a clinically relevant proportion of [the patients] can be detected by applying a model containing age, BASFI [Bath Ankylosing Spondylitis Functional Index], and ESR [erythrocyte sedimentation rate].” 

The cross-sectional study included 806 patients from a Spanish multicenter cohort. Researchers aimed to compare atherosclerosis disease burden among 639 participants with ankylosing spondylitis (AS) and 167 participants with nr-axSpA. To do so, they used SCORE, a European cardiovascular disease risk assessment tool, as well as carotid ultrasound, which determined carotid intima-media wall thickness and detected the presence of carotid plaques.

Compared with patients with nr-axSpA, patients with AS were older with more cardiovascular risk factors, higher c-reactive protein levels, and higher ESR levels. Nevertheless, adjusted analysis showed no difference in carotid plaque prevalence or in carotid intima-media wall thickness between the patient groups. 

“The percentage of patients reclassified from the low and moderate cardiovascular risk categories to the very high-risk category due to the presence of carotid plaques was comparable in AS and nr-axSpA (10.7% versus 10.1% and 40.5% versus 45.5%, respectively),” researchers reported. “A model containing age, BASFI, and ESR applied to moderate-risk axSpA patients identified 41% of these patients as having very high-risk … with high specificity (88%).” 

Reference:

González Mazón I, Rueda-Gotor J, Ferraz-Amaro I, et al. Subclinical atherosclerotic disease in ankylosing spondylitis and non-radiographic axial spondyloarthritis. A multicenter study on 806 patients [published online ahead of print, 2021 Feb 13]. Semin Arthritis Rheum. 2021;51(2):395-403. doi:10.1016/j.semarthrit.2021.02.003