AB0758 Subclinical Atherosclerosis is not Accelerated in Well-Controlled Ankylosing Spondylitis: Original Data and Meta-Analysis of Published Studies

BackgroundChronic inflammatory rheumatic diseases associate with increased risk of cardiovascular disease (CVD) in part due to accelerated atherosclerosis. While this is well established for rheumatoid arthritis (1), data on ankylosing spondylitis (AS) is limited and the relative contribution of inflammation versus classical cardiovascular risk factors remains a matter of controversy (2).ObjectivesTo address this controversy in an original, carefully designed study of subclinical atherosclerosis in AS patients, as well as in a meta-analysis of previous studies.MethodsAtheromatic plaques in carotid and femoral arteries, carotid hypertrophy (intima-media thickness-IMT; cross sectional area) and carotid stiffness by ultrasound, as well as aortic stiffness by pulse wave velocity were examined in consecutive non-diabetic CVD-free, AS patients. Apparently healthy individuals carefully matched 1:1 with patients for age, gender, smoking, dyslipidemia and hypertension served as controls. A meta-analysis of those studies that examined subclinical atherosclerosis in AS patients versus controls with comparable CVD risk factors, published up to June 2014, was also performed. Studies were subsequently stratified according to the mean level of disease activity (BASDAI> or or