Giollo A, et al. - This study was meant to identify the determinants of an accelerated subclinical atherosclerosis in patients with spondyloarthritis (SpA). Findings revealed that in SpA patients without overt cardiovascular (CV) disease, a decrease in renal function and radiographic damage was associated with the development of subclinical accelerated atherosclerosis. Longitudinal assessment of carotid intima-media thickness (cIMT) could be useful to analyze the individual CV risk of these patients in order to improve their prognostic stratification.

• This study included 66 patients free of CVD classified according to ASAS criteria.
• The patients were evaluated at baseline and after 13.5 ± 3.6 months.
• To determine the extent of subclinical atherosclerosis, ultrasound measurements of carotid intima-media thickness (cIMT) and distensibility coefficient (cDC) were used.
• cIMT progression rate was calculated dividing the cIMT change by the time between the scans.
• Accelerated atherosclerosis was defined as the top cIMT progression rate quartile.
• The mean Framingham Risk Score was 14 ± 11%, at baseline .
• At follow-up, in 39 patients cIMT was increased (59%; mean difference 0.01 ± 0.10; p = 0.334).
• Mean cIMT progression rate was 0.01 mm/year (95% CI - 0.02 to 0.03).
• cDC was unchanged at follow-up.
• At baseline, patients with accelerated atherosclerosis (n = 16) had significantly higher serum creatinine and lower glomerular filtration rate (eGFR).
• In multiple logistic regression, only eGFR and the presence of syndesmophytes were associated with an accelerated atherosclerosis, independent of traditional cardiovascular risk factors.