P4.02 BASELINE CRP BUT NOT NSAID-USE PREDICTS FUTURE INCREASED ARTERIAL STIFFNESS IN ANKYLOSING SPONDYLITIS: RESULTS AFTER 5-YEAR FOLLOW UP

• Main Authors: I.J. Berg, A.G. Semb, D. van der Heijde, T.K. Kvien, H. Dagfinrud, S.A. Provan
• Format: Article
• Language: English
• Published: Atlantis Press 2013-11-01
• Series: Artery Research
• Online Access: https://www.atlantis-press.com/article/125939007/view

Objective: Patients with ankylosing spondylitis (AS) have an increased risk of CVD, but previous studies have not shown a worsened risk profile regarding traditional cardiovascular risk factors. The objective was to investigate whether baseline CRP predicts future increased central arterial stiffness. Methods: 5-year follow-up study of hospital recruited AS patients, with examinations in 2003 and 2008–2009. Information on demographics, co-morbidities and medication was assessed from questionnaires. Baseline CRP was measured in 2003. Arterial stiffness, measured as Augmentation index (AIx), was recorded in 2008–2009 (Sphygmocor apparatus, At Cor). Statistical analyses were performed using SPSS 20. Univariate associations between AIx and baseline predictors (education, smoking habits, BMI, use of NSAID and disease modifying anti-rheumatic drugs (DMARD), CRP) and factors known to have an effect on AIx (Central mean arterial pressure (CMAP), height, use of statins and antihypertensives) were adjusted for age and gender. Variables with a p-value<0.2 were included in a multivariate model. Non-significant variables were removed stepwise until only significant variables remained. Results: 85 AS patients participated in this study. Baseline mean (SD) age was 47.3 (12.6) years. 59% were male, 25% smokers. Median (IQR) CRP (mg/l) 4 (2–13). In the multivariate linear regression models CRP was independently associated with higher future AIx (table). Conclusion: Elevated CRP but not NSAID-use predicted higher future AIx, indicating that inflammation is a risk factor of CVD in AS. Variables Univariate beta (95% CI) p-value Multivariate beta (95% CI) p-value Age (years)* 0.7 (0.5–0.9) <0.001 0.5 (0.3–0.7) <0.001 Gender, male* −12.0 (−17.3−−6.7) <0.001 −10.9 (−14.4−−7.5) <0.001 Education>12 years −1.0 (−5.3−3.3)* 0.63 Baseline predictors 2003 Current smoking 3.9 (−0.5 −8.3)* 0.08 BMI (m2/kg) 0.8 (0.0–1.6)* 0.04 NSAID 2.7 (−2.5–7.8)* 0.30 DMARD −3.2 (−8.3 −1.9)* 0.22 CRP (mg/l) 0.2 (−0.0–0.3)* 0.06 0.2 (0.0–0.3) 0.02 Current factors 2008 Height (cm) −0.3 (−0.5−0.0)* 0.03 CMAP (mmHg) 0.3 (0.1–0.5)* <0.001 0.3 (0.1–0.4) <0.001 Statins 6.2 (0.9–11.6)* 0.02 6.3 (1.5–11.2) 0.01 Antihypertensives 0.8 (−3.9–5.5)* 0.74 *Adjusted age and gender