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Carotid Intima Media Thickness as a Marker of Atherosclerosis in Ankylosing Spondylitis

DOI: 10.1155/2014/839135

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Abstract:

Aim. Increased cardiovascular morbidity and mortality have been observed in ankylosing spondylitis because of accelerated atherosclerosis. We measured carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in this study. Methods. In this study 37 cases of AS and the same number of matched individuals were recruited. CIMT measurements were done using B-mode ultrasound. Disease activity was assessed using Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. Results. Mean age of the study groups was 29.43?±?9.00 years. Average disease duration was 65.62?±?54.92 months. Twenty-eight (75.68%) of cases were HLA B-27 positive. A significantly increased CIMT was observed in cases as compared to control group (0.62?±?0.12 versus 0.54?±?0.04; ). CIMT in the cases group positively correlated with age , duration of disease , and BASMI and negatively correlated with ESR . Conclusions. Patients of AS had a higher CIMT than those of the control group. CIMT correlated with disease chronicity. 1. Introduction Ankylosing spondylitis (AS) is a chronic inflammatory disease of the axial skeleton, also associated with peripheral arthritis and cardiac, ocular, and gastrointestinal manifestations. Cardiovascular mortality has been found to be increased in rheumatic diseases, which is attributed to accelerated atherosclerosis [1, 2]. A wide range of cardiovascular features are associated with ankylosing spondylitis, namely, aortitis, aortic regurgitation, and conduction abnormalities [3, 4], along with an increased risk of atherosclerosis related cardiovascular events like myocardial infarction and stroke, leading to a significantly increased mortality [5, 6]. Chronic systemic inflammation is implicated as the driving force behind accelerated atherosclerosis in rheumatic diseases [7, 8]. Among the various screening methods, carotid intima media thickness (CIMT) has gained wide acceptance as a marker of atherosclerosis predicting future cardiovascular events [9, 10]. In this study we have compared CIMT in patients of AS with a matched group of healthy individuals. We also studied the correlation between CIMT and Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate

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