DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182290

Carotid intima medial thickness as a marker of atherosclerosis in ankylosing spondylitis

Sarvagya Mishra, Abhishek Singhai, Praksah Joshi, Rajesh Kumar Jha

Abstract


Background: Ankylosing Spondylitis (AS) is an inflammatory disorder of unknown cause that primarily affects the axial skeleton; peripheral joints and extraarticular structures are also frequently involved. The present study was planned to generate more data on this subject with the aim of measuring the CIMT in AS, as these patients are more prone to develop early atherosclerosis and develop early macro vascular complications like CAD.

Methods: It was a cross-sectional study with a sample size of 60 patients. The study group included 30 patients with a known history or clinical features suggestive of AS. The control group included 30 normal adult subjects without any previous history. All subjects included in the study underwent detailed clinical history, analysis, physical examination and necessary investigations.

Results: CIMT in the control group was 0.54±0.19 mm and in the AS group was 0.65±0.21 mm. The difference was found to be statistically significant (P<0.05), showing a higher CIMT in the AS group in comparison to the control group. The mean age in the control group was 30.43±6.14 years and in the AS group was 29.3±10.1 years. The difference was found to be statistically not significant (p>0.05), showing comparable age between the two groups. The age to CIMT showed positive correlation which was statistically significant (r=0.405, p=0.026).

Conclusions: Results of this study showed that there is a higher prevalence of subclinical atherosclerosis (20%) in AS patients as compared to controls as evidenced by a higher CIMT. Every effort should be made in order to control inflammation and traditional risk factors in this population, to avoid the consequences of accelerated atherogenesis.


Keywords


Ankylosing spondylitis, Atherosclerosis, Cholesterol

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References


Sokka T, Abelson B, Pincus T. Mortality in rheumatoid arthritis: 2008 update. Clin Exp Rheumatol. 2008;26(Suppl.51):S35-S61.

Zochling J, Braun J. Mortality in ankylosing spondylitis. Clin Exp Rheumatol. 2008;26(Suppl.51):S80-S84.

Han C, Robinson DW Jr, Hackett MV, Paramore LC, Fraeman KH, Bala MV. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol. 2006;33:2167-72.

Crouse JR, Harpold GH, Kahl FR, Toole JF, McKinney WM: Evaluation of a scoring system for extracranial carotid atherosclerosis extent with B-mode ultrasound. Stroke. 1986;17:270-5.

Bond MG, Wilmoth SK, Enevold GL, Strickland HL: Detection and monitoring of asymptomatic atherosclerosis in clinical trials. American J Medicine. 1989;86:33-6.

Pignoli P, Tremoli E, Oreste P, Paoletti R: Intimal plus medial thickness of the arterial wall: A direct measurement with ultrasound imaging. Circulation. 1986;74:1399-140.

Bonora E, Tessari R, Micciolo R, Zenere M, Targher G, Padovani R, et al. Intimal-medial thickness of the carotid artery in nondiabetic and non-insulin-dependent diabetic subjects: relationship with insulin resistance. Diabetes Care. 1997;20:627-31.

Jadhav UM, Kadam NN. Carotid intima-media thickness as an independent predictor of coronary artery disease. Indian Heart J. 2001;53:458-62.

Yan ping liu, Ying Zhu, Zifhang Yang, Bo Zao. Gender difference in carotid intima-media thickness in type 2 diabetic patients: a 4-year follow-up study. Cardiovascular Diabetology. 2012;11(1):51.

Matangi MF, Armstrong DW, Nault M. Normal values for common carotid intimal media thickness should be adjusted for age, Rev Esp Cardiol. 2010;63(1):97-102.

Sharma SK, Prasad KT, Handa R. Sharma SK. increased prevalence of subclinical atherosclerosis in ankylosing spondylitis. Indian J Rheumatol. 2015;10:53-7.

Skare TL, Verceze GC, de Oliveira AA, Perreto S. Carotid intima-media thickness in spondyloarthritis patients. Sao Paulo Med J. 2013;131(2):100-5.

Yamasaki Y, Kodama M, Nishizawa H, Sakamoto K, Matsuhisa M, Kajimoto Y, et al. Carotid intima media thickness in Japanese type 2 diabetic subjects: predictors of progression and relationship with incident coronary heart disease. Diabetes Care. 2000;23:1310-5.