Ankylosing spondylitis (AS) is associated with an increased prevalence of left ventricular (LV) hypertrophy, which is reflective of subclinical cardiovascular disease (CVD), independent of CV risk factors, according to the results of a cross-sectional study published in The Journal of Rheumatology.

The investigators of the current study sought to evaluate whether having AS was linked to an increased prevalence of LV hypertrophy, as AS is associated with an increased risk for CVD and LV hypertrophy is a strong precursor for clinical CVD. They obtained clinical and electrocardiographic data from a total of 139 patients with AS and 126 age- and sex-matched control patients. LV mass was calculated on the basis of current guidelines and indexed to height. The presence of LV hypertrophy was established if LV mass index was >49.2 g/m2.7 in men and >46.7 g/m2.7 in women.

The mean age of patients with AS was 49.1±11.7 years, and 60% were men. In patients with AS vs control patients, the presence of hypertension (35% vs 41%) and diabetes (5% vs 2%) was similar, whereas those with AS had significantly higher serum C-reactive (CRP) levels compared with control patients (P <.001). The prevalence of LV hypertrophy was also significantly higher among patients with AS compared with control patients (15% vs 6%; P =.01).


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Multivariable logistic regression analysis demonstrated that the presence of AS was associated with a 6.3-fold higher odds ratio (95% CI, 2.1-19.3; P =.001) of having LV hypertrophy, after adjusting for sex, hypertension, diabetes, and obesity. Moreover, multivariable linear regression analysis showed that the presence of AS was also linked to a higher LV mass (β, 0.15; P =.007) after adjusting for CV risk factors, including sex, body mass index, systolic blood pressure, diabetes, and serum CRP levels (P <.001).

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The investigators concluded that the association between AS and increased prevalence of LV hypertrophy, independent of CV risk factors, strengthens the indication for performing a thorough CVD risk assessment in patients with inflammatory disorders.

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Reference

Midtbø H, Gerdts E, Berg IJ, Rollefstad S, Jonsson R, Semb AG. Ankylosing spondylitis is associated with increased prevalence of left ventricular hypertrophy [published online June 1, 2018]. J Rheumatol. doi: 10.3899/jrheum.171124s