AB0880 PROGNOSTIC SIGNIFICANCE OF DISEASE DURATION, AGE, AND PERSISTENT INFLAMMATION IN AORTIC VALVE DEGENERATIVE LESIONS AMONG PATIENTS WITH SPONDYLOARTHRITIS
Authors: H. S. Park, A. Laiz, P. Moya Alvarado, L. Sainz Comas, A. García-Alija, A. Casals Urquiza, C. Díaz-Torné, B. P. Magallares, I. Castellví, S. P. Fernandez-Sanchez, J. Bernardez, H. Codes, J. L. Tandaipan, C. Pitarch, A. Garcia Guillen, C. Marco Pascual, A. Lopez-Ferrer, L. Puig, H. Corominas
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Age, calcification and inflammatory burden may produce degenerative lesions in the aortic valve. It is described that aortic root dilatation and severe sclerosis of the aortic valve is more frequently observed in spondyloarthritis (SpA) patients compared to the population of patients without spondyloarthritis [1]. <h3>Objectives:</h3> Evaluate the association between years of disease evolution, age and total time of persistent inflammation as prognostic factors for aortic root dilatation and sclerosis of the aortic valve. Identify prognostic factors and comorbidities associated with aortic root dilatation and sclerosis of the aortic valve within the context of the specified disease. <h3>Methods:</h3> An ambispective observational study was conducted at a tertiary referral university hospital, involving 482 SpA patients meeting ASAS criteria, attending the SpA clinic between July 2022 and August 2023. The inclusion criteria were patients followed up in our center since diagnosis of SpA for full history availability. Echocardiography was performed on all these patients to screen for cardiac manifestations related to the disease, if they had not undergone one previously. Data were gathered by reviewing electronic and paper hospital databases, supplemented by the Catalan Institute of Health's medical history database. Missing data were prospectively collected through patient interviews. The primary outcomes were aortic root diameter adjusted by body surface area and the presence of valve sclerosis measured by echocardiography. Explanatory variables included the approximate total time of active disease (Figure 1), time since symptom onset, and age. Logistic and linear univariate regression analyses were performed. <h3>Results:</h3> A total of 246 patients met inclusion criteria for analysis. The baseline characteristics of the population and the results of the regressions with the primary outcomes are summarized (Table 1). The median time of follow-up was 9 years. As for the aortic root dilatation, three fold risk increase was observed for male sex with statistical significance. Age, years since first articular symptom until SpA diagnosis and years of disease evolution showed significant association but not years since first extraarticular symptom. As for the valve sclerosis, moderate to high risk increase was observed for hypertension, dyslipidemia, psoriasis, peripheral involvement and erosive disease with statistical significance. As for time related variables only years since first extra-articular symptoms showed statistically significant association. <b>Table 1.</b> <h3>Conclusion:</h3> -Male sex showed a strong association with aortic root dilatation as it is known [2]. There was no association with axial disease. -Patients with a greater burden of inflammation due to clinical complexity (erosive disease and extra-articular manifestations), as well as those with a higher duration of persistent CRP elevation, were associated with valve sclerosis. <h3>REFERENCES:</h3> [1] Front Cardiovasc Med. 2021;8:719523. [2] J Am Soc Echocardiogr. 2023 Oct;36(10):1126. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>