Investigation of effects of different treatment modalities on structural and functional vessel wall properties in patients with ankylosing spondylitis

Aim: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that is associated with increased cardiovascular burden. The aim of this study was to investigate vascular structural and functional changes in patients with AS, with special emphasis on the effects of different treatment modalities, through evaluation of level of vascular stiffness (pulse wave velocity [PVW]) and carotid intima media thickness (IMT-C). Methods: A total of 67 AS patients, and age, sex, body mass index (BMI) smoking status, lipid profiles and blood pressure-matched healthy control subjects (n = 34) were studied. Of these, 34 patients were on anti-TNF alpha and 33 on non steroid anti inflammatory drugs (NSAIDs). The IMT-C and PWV values of the right common carotid artery were measured by high-resolution ultrasound. Results: The AS patients (n = 67) had significantly higher PWV values than the controls [9.0 +/- 1.49 m/sec vs. 8.27 +/- 0.90 m/sec, P = 0.004; 95% confidence interval (CI), -1.22 to -0.24]. Multiple stepwise linear regression analysis revealed that PWV could only be explained by systolic blood pressure (P < 0.05) and IMT (P < 0.05) in AS. Even though IMT-C in anti-TNF alpha treated group was higher compared to the NSAID treated group, it was not statistically significant (P = 0.5). Conclusion: PWV was found to be higher in AS patients than in the control group, and there was no significant difference between the average PWV values of AS patients treated with anti-TNF alpha or NSAIDs. (C) 2010 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.,