IJCS | Volume 32, Nº1, January/ February 2019

13 Table 2 - Cardiovascular risk factors of the individuals with and without spondyloarthritis assessed in this study Variables Spondyloarthritis p value No Yes Family history No 76.0 (38) 73.2 (30) 0.757 Yes 24.0 (12) 26.8 (11) No information 0 1 Smoking No 90.0 (45) 92.9 (39) 0.628 Yes 10.0 (5) 7.1 (3) Alcoholism No 60.0 (30) 71.4 (30) 0.252 Yes 40.0 (20) 28.6 (12) BMI 27.99 ± 0.76 27.33 ± 0.90 0.575 SAH No 64.0 (32) 57.1 (24) 0.502 Yes 36.0 (18) 42.9 (18) Total cholesterol 170.60 ± 5.36 180.67 ± 6.66 0.237 HDL 43.13 ± 2,45 45.81 ± 2.18 0.420 LDL 88.87 ± 6.36 110.79 ± 5.65 0.012 Triglycerides 137.58 ± 14.19 123.40 ± 11.76 0.455 Glycated hemoglobin 6.65 ± 1.41 5.59 ± 0.08 0.484 Uric acid 6.02 ± 0.26 5.22 ± 0.20 0.019 hs-CRP 2.35 ± 0.31 16.10 ± 8.88 0.130 Microalbuminuria 3.87 ± 0.95 8.31 ± 2.04 0.053 Metabolic syndrome No 62.0 (31) 69.0 (29) 0.480 Yes 38.0 (19) 31.0 (13) Interleukin-6 4.62 ± 0.48 4.84 ± 0.80 0.806 BMI: body mass index; SAH: systemic arterial hypertension; hs-CRP: high-sensitivity C-reactive protein. The results are expressed as mean ± standard error of the mean or relative frequency (absolute frequency). P value in the Student t test (quantitative variables) or the chi-square test (qualitative variables). Silva Junior et al. Cardiovascular disease and ankylosing spondylitis Int J Cardiovasc Sci. 2019;32(1)10-18 Original Article To assess the cardiovascular risk of well-controlled patients, and thuswith lower inflammation level, the global cardiovascular risk was calculated separately in patients withASDAS-CRP < 2 and lowdisease activity level, but no significant statistical differencewas found between the CG and the AS group patients with that characteristic. Manifest cardiovascular disease Most individuals assessed in this study had no clinically manifest CVD, with prevalence between 2% and 26%, and valvular dysfunctions were the most frequent change, although all of them were mild. The percentage of individuals with right bundle-branch block was higher in the AS group than in the CG. The following variables showed no association with the presence or absence of AS: stroke, acute myocardial infarction, CABG, angioplasty, PRV/POAD, presence of carotid plaques and other findings on echocardiogram and electrocardiogram. None of the individuals in the CG and AS group showed significant carotid obstruction (plaque obstruction ≥ 50% of the lumen) (Table 3). Subclinical cardiovascular disease None of the individuals achieved the cutoff values for the occurrence of microalbuminuria (> 30 mg/g) or altered ABI (< 0.9 and > 1.3); in addition, the mean values of ABI and microalbuminuria were similar in both groups. Carotid plaques without significant obstruction (< 50% of the lumen) were slightly more frequent in the AS group [CG: 12.2% (n = 6); AS: 21.4% (n = 9)], but with no significant statistical difference (p = 0.239). However, as shown in Figure 1, CIMT was higher in the AS group (p = 0.018), and the cutoff value to determine altered CIMT (> 1 mm) was more often observed in the AS group [CG: 2.3 (n = 1); AS: 24.2 (n = 8)] (p = 0.003). This difference was observed when individuals with carotid plaques were excluded. Considering only the individuals with carotid plaques, no significant difference regarding CIMT was observed between the groups (CG: 0.78 ± 0.13; AS: 1.45 ± 2.12) (p = 0.464). Ankylosing spondylitis activity and specific data Most individuals were HLA positive (64.3%, n = 27) and had exclusive (33.3%, n = 14) or predominantly (61.9%, n = 26) axial clinical manifestations and extra- association between the presence or absence of AS and the cardiovascular risk classification.