POS0970 ASSESSMENT OF THE ASSOCIATION BETWEEN ESTIMATED CARDIOVASCULAR RISK AND MASEI INDEX IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS
Authors: I. C. Aranda-Valera, I. Gómez García, M. L. Ladehesa Pineda, M. C. Ábalos-Aguilera, C. López-Medina, E. Collantes Estevez
Journal: Annals of the Rheumatic Diseases (2021)

Background: It has been shown that the cardiovascular risk (CV) in spondyloarthritis (SpA) patients is higher than that of the general population. Furthermore, an association has recently been described between structural damage at the axial level and an increase in estimated CV risk 1 . Objectives: To evaluate the association between the estimated cardiovascular risk (CV) and the presence of subclinical atherosclerosis with the MASEI index (Madrid Sonographic Enthesis Index) in patients with axial spondyloarthritis (Ax-SpA) as an expression of peripheral enthesitis. Methods: Cross-sectional study performed in 103 patients with ax-SpA from the Córdoba AxSpA Task force, Registry and Outcomes (CASTRO), in which patients undergoing treatment with biological therapy and with a previous history of CV event were excluded. Clinical data, disease activity data and factors related to CV risk were collected, as well as the presence of persistently elevated CRP levels in the five years prior to the study visit. The SCORE index was calculated, as well as the thickness of the carotid intima media (CIMT) and the MASEI index, both measured by ultrasound. The association between MASEI-SCORE and MASEI-atheroma plaques was evaluated using generalized linear models (GLM), adjusted for time of evolution of the disease, disease activity and smoking. Results: Of the patients included, 35 were men (34.0%), with a mean age of 45.2 (±12.1) years and time of evolution of the disease of 18.5 (±13.0) years. The mean MASEI score was 13.6 (±9.1), and the mean SCORE score was 8.1 (±8.9). The GLM regressions showed that the MASEI was independently associated with the SCORE (coefficient β 0.22; 95% CI 0.02-0.43) adjusted for the duration of the disease, smoking, and the presence of persistent CRP (Table 1A). The MASEI index was also significantly associated with the CIMT, although these differences disappeared when the model was adjusted for other factors (Table 1B). Table 1. A. Association between MASEI and SCORE adjusting for disease duration, smoking status and CRP. Crude model Adjusted for disease duration Adjusted for disease duration and smoking Adjusted for disease duration, smoking and CRP β coefficient (95%CI ) p-value β coefficient (95%CI ) p-value β coefficient (95%CI ) p-value β coefficient (95%CI ) p-value MASEI 0.37 (0.20-0.55) &lt;0.001 0.25 (0.08-0.42) 0.006 0.25 (0.09-0.42) 0.004 0.22 (0.02-0.43) 0.039 Conclusion: In patients with ax-SpA, peripheral enthetic damage measured by the MASEI index is associated with an increase in estimated CV risk independently of the time of evolution, smoking and levels of CRP. References: [1]Ladehesa-Pineda ML, Arias-de la Rosa I, López-Medina C, et al. Assesment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis. Ther Adv Musculoskelet Dis 2020;12:1-15 Table 1. B. Association between MASEI and intima media thickness (IMT) adjusting for disease duration, smoking status and CRP. Crude model Adjusted for disease duration Adjusted for disease duration and smoking Adjusted for disease duration, smoking and CRP β coefficient (95%CI ) p-value β coefficient (95%CI ) p-value β coefficient (95%CI ) p-value β coefficient (95%CI ) p-value MASEI 0.01 (0.00-0.01 ) 0.041 0.003 (-0.01-0.004 ) 0.178 0.002 (-0.001-0.004 ) 0.149 0.002 (-0.001-0.005 ) 0.226 Disclosure of Interests: None declared.