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Sex differences in cardiovascular and disease-related features in axial spondyloarthritis. A multicenter study of 912 patients

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Autores de IDIVAL

Autores ajenos al IDIVAL

  • Ferraz-Amaro I
  • Hernández-Hernández V
  • Quevedo-Abeledo JC
  • Rodríguez-Lozano C
  • Lopez-Medina C
  • Ladehesa-Pineda ML
  • Castañeda S
  • Vicente EF
  • Fernández-Carballido C
  • Martínez-Vidal MP
  • Castro-Corredor D
  • Anino-Fernández J
  • Peiteado D
  • Plasencia-Rodríguez C
  • Vivar MLG
  • Galíndez-Agirregoikoa E
  • Urionagüena-Onaindia I
  • Perez EM
  • Díaz CF

Unidades

Abstract

Objectives: To determine the potential impact of sex-specific disease-related characteristics on cardiovascular (CV) disease in axial spondyloarthritis (axSpA).Methods: Cross-sectional study of the Spanish AtheSpAin cohort to study CV disease in axSpA. Data on carotid ultrasound and CV disease and disease-related features were collected.Results: 611 men and 301 women were recruited. Classic CV risk factors were significantly less prevalent in women, who also showed a lower frequency of carotid plaques (p = 0.001), lower carotid intima-media thickness (IMT) values (p<0.001) and CV events (p = 0.008). However, after adjustment for classic CV risk factors, only the differences with respect to carotid IMT remained statistically significant. Women showed higher ESR at diagnosis (p = 0.038), and more active disease (ASDAS, p = 0.012, and BASDAI, p<0.001). They had shorter disease duration (p<0.001), lower prevalence of psoriasis (p = 0.008), less structural damage (mSASSS, p<0.001), and less mobility limitation (BASMI, p = 0.033). To establish whether these findings could lead to sex differences in CV disease burden, we compared the prevalence of carotid plaques in men and women with the same level of CV risk stratified according to the Systematic Coronary Risk Evaluation (SCORE). Men included in the low-moderate CV risk SCORE category had more carotid plaques (p = 0.050), along with longer disease duration (p = 0.004), higher mSASSS (p = 0.001) and psoriasis (p = 0.023). In contrast, in the high-very high-risk SCORE category, carotid plaques were observed more frequently in women (p = 0.028), who were characterized as having worse BASFI (p = 0.011), BASDAI (p<0.001) and ASDAS (p = 0.027).Conclusion: Disease-related features may influence the expression of atherosclerosis in patients with axSpA. This may be especially applicable to women at high CV risk, characterized by greater disease severity and more severe subclinical atherosclerosis than men, suggesting a stronger interaction between disease activity and athero-sclerosis in women with axSpA.

Copyright © 2023. Published by Elsevier Inc.

Datos de la publicación

ISSN/ISSNe:
0049-0172, 1532-866X

SEMINARS IN ARTHRITIS AND RHEUMATISM  W B SAUNDERS CO-ELSEVIER INC

Tipo:
Article
Páginas:
152198-152198
PubMed:
37058848
Enlace a otro recurso:
www.sciencedirect.com

Citas Recibidas en Web of Science: 5

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Keywords

  • Axial spondyloarthritis; Sex; Women; Atherosclerosis; Cardiovascular

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