IJCS | Volume 32, Nº1, January/ February 2019

DOI: 10.5935/2359-4802.20180076 10 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(1)10-18 Mailing Adress: Delcio Gonçalves da Silva Junior Rua Praia de Piatã, 51, Postal Code: 79022-490, Autonomista, Campo Grande, MS - Brazil. E-mail: delcio@clinicacdc.com.br Cardiovascular Disease in Patients with Ankylosing Spondylitis from the Rheumatology Outpatient Clinic of the UFMS-affiliated Hospital Delcio Gonçalves da Silva Junio r a nd Izaias Pereira da Costa Universidade Federal de Mato Grosso do Sul, Mato Grosso do Sul, MS - Brazil Manuscript received November 27, 2017, revised manuscript April 23, 2018, accepted June 19, 2018. Abstract Background: Cardiovascular diseases are a major cause of morbidity and mortality today. Despite its wide distribution, it presents particularly prevalent in certain groups of individuals, particularly when exposed to a higher degree of inflammation, giving increased cardiovascular risk. Rheumatic diseases expose their holders to this increased cardiovascular risk condition; however only recently have been associated with spondyloarthritis, particularly ankylosing spondylitis (AS). For being a classically autoimmune disease related to HLA histocompatibility system, AS may present phenotypic variations in different ethnic groups with possible diverse cardiovascular consequences. Objectives: To estimate the prevalence of cardiovascular disease (CVD) and the cardiovascular risk profile, correlating the time since diagnosis and activity of ankylosing spondylitis (AS) in patients from the rheumatology outpatient clinic of the UFMS-affiliated hospital. Methods: Of 55 patients with AS, 42 were selected consecutively and compared to a control group (CG) in a cross- sectional study. Patients with diabetes, indigenous background and pregnant women were excluded. Quantitative variables were assessed by use of Student t test, while qualitative variables, by chi-square test. The patients underwent electrocardiography, echocardiography and carotid Doppler examination, measurement of serum lipid levels and inflammatory markers, and were stratified according to global cardiovascular risk. The AS activity and impairment were evaluated by use of the BASMI, BASDAI, BASFI and ASDAS. Results: Mean age, 42.87 ± 12.37 years; time since AS diagnosis, 10.76 ± 8.74 years. There was no difference in cardiovascular risk stratification between the groups, most of the patients being at high or moderate risk (AS: 64.3%, and CG: 52%, p = 0.134). The prevalence of manifest CVD (2%) showed no difference between the groups, except for right bundle-branch block (AS: 14%, and CG: 2%, p = 0.027). The prevalence of subclinical CVD showed no difference between the groups, except for higher carotid medial-intimal thickness (CIMT) in the AS group (AS: 1.82 ± 2.63, and CG: 0.67 ± 0.16, p = 0.018). There was no correlation between AS activity or inflammatory markers and CVD, but with time since AS diagnosis and CIMT (p = 0.039, r = 0.328). Conclusions: Prevalence of CVD and risk factors was similar in the groups. Subclinical atherosclerosis degree was higher in the AS group, related to the time since diagnosis, but was independent of the cardiovascular risk factors or inflammation. Most patients with AS are at high cardiovascular risk. (Int J Cardiovasc Sci. 2019;32(1)10-18) Keywords: Cardiovascular Diseases; Risk Factors; Cross-Sectional Studies; Spondylitis, Ankylosing/complications; Spondylitis, Ankylosing/ diagnosis. Introduction Cardiovascular diseases (CVD) are currently a major cause of morbidity and mortality. Recent data from the World Health Organization have shown that 30% of the total of deaths worldwide in past decades result from CVD, approximately 17 million individuals. 1,2 The traditional risk factors for CVD, such as diabetes,