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Clinical Rheumatology
Published in: Clinical Rheumatology 10/2023

Open Access 07-07-2023 | Ankylosing Spondylitis | REVIEW ARTICLE

Cardiovascular risk in axial spondyloarthritis—a systematic review

Authors: Rainer Hintenberger, Barbara Affenzeller, Valeriia Vladychuk, Herwig Pieringer

Published in: Clinical Rheumatology | Issue 10/2023

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Abstract

Cardiovascular manifestations are common in patients suffering axial spondyloarthritis and can result in substantial morbidity and disease burden. To give an overview of this important aspect of axial spondyloarthritis, we conducted a systematic literature search of all articles published between January 2000 and 25 May 2023 on cardiovascular manifestations. Using PubMed and SCOPUS, 123 out of 6792 articles were identified and included in this review. Non-radiographic axial spondyloarthritis seems to be underrepresented in studies; thus, more evidence for ankylosing spondylitis exists. All in all, we found some traditional risk factors that led to higher cardiovascular disease burden or major cardiovascular events. These specific risk factors seem to be more aggressive in patients with spondyloarthropathies and have a strong connection to high or long-standing disease activity. Since disease activity is a major driver of morbidity, diagnostic, therapeutic, and lifestyle interventions are crucial for better outcomes.
Key Points
• Several studies on axial spondyloarthritis and associated cardiovascular diseases have been conducted in the last few years addressing risk stratification of these patients including artificial intelligence.
• Recent data suggest distinct manifestations of cardiovascular disease entities among men and women which the treating physician needs to be aware of.
• Rheumatologists need to screen axial spondyloarthritis patients for emerging cardiovascular disease and should aim at reducing traditional risk factors like hyperlipidemia, hypertension, and smoking as well as disease activity.
Appendix
Available only for authorised users
Literature
1.
Stovall R, Van Der Horst-Bruinsma IE, Liu S-H, Rusman T, Gensler LS (2022) Sexual dimorphism in the prevalence, manifestation and outcomes of axial spondyloarthritis. Nat Rev Rheumatol 18(11):657–669PubMed
2.
Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJ et al (2017) EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis 76(1):17–28PubMed
3.
Essers I, Stolwijk C, Boonen A, De Bruin ML, Bazelier MT, de Vries F et al (2016) Ankylosing spondylitis and risk of ischaemic heart disease: a population-based cohort study. Ann Rheum Dis 75(1):203–209PubMed
4.
Tsai WC, Ou TT, Yen JH, Wu CC, Tung YC (2015) Long-term frequent use of non-steroidal anti-inflammatory drugs might protect patients with ankylosing spondylitis from cardiovascular diseases: a nationwide case-control study. PLoS One 10(5):e0126347PubMedPubMedCentral
5.
Navarini L, Caso F, Costa L, Currado D, Stola L, Perrotta F et al (2020) Cardiovascular risk prediction in ankylosing spondylitis: from traditional scores to machine learning assessment. Rheumatol Ther 7(4):867–882PubMedPubMedCentral
6.
Colaco K, Ocampo V, Ayala AP, Harvey P, Gladman DD, Piguet V et al (2020) Predictive utility of cardiovascular risk prediction algorithms in inflammatory rheumatic diseases: a systematic review. J Rheumatol 47(6):928–938PubMed
7.
Page MJ, Mckenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, The PRISMA et al (2020) statement: an updated guideline for reporting systematic reviews. BMJ 2021:n71
8.
Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT (2004) Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis. Semin Arthritis Rheum 34(3):585–592PubMed
9.
Brown WM, Doll R (1965) Mortality from cancer and other causes after radiotherapy for ankylosing spondylitis. Br Med J 2(5474):1327–1332PubMedPubMedCentral
10.
Peters MJL, Nielen MMJ, Raterman HG, Verheij RA, Schellevis FG, Nurmohamed MT (2009) Increased cardiovascular disease in patients with inflammatory arthritis in primary care: a cross-sectional observation. J Rheumatol 36(9):1866–1868PubMed
11.
Kang JH, Chen YH, Lin HC (2010) Comorbidity profiles among patients with ankylosing spondylitis: a nationwide population-based study. Ann Rheum Dis 69(6):1165–1168PubMed
12.
Bengtsson K, Forsblad-d’Elia H, Lie E, Klingberg E, Dehlin M, Exarchou S et al (2017) Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events? A prospective nationwide population-based cohort study. Arthritis Res Ther. 19(1):102PubMedPubMedCentral
13.
Kim JH, Choi IA (2021) Cardiovascular morbidity and mortality in patients with spondyloarthritis: a meta-analysis. Int J Rheum Dis 24(4):477–486PubMed
14.
Lin CW, Huang YP, Chiu YH, Ho YT, Pan SL (2014) Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study. PLoS One 9(4):e94027PubMedPubMedCentral
15.
Zhao SS, Robertson S, Reich T, Harrison NL, Moots RJ, Goodson NJ (2020) Prevalence and impact of comorbidities in axial spondyloarthritis: systematic review and meta-analysis. Rheumatology 59(4):iv47–iv57PubMedPubMedCentral
16.
Bakland G, Gran JT, Nossent JC (2011) Increased mortality in ankylosing spondylitis is related to disease activity. Ann Rheum Dis 70(11):1921–1925PubMed
17.
Chaudhary H, Bohra N, Syed K, Donato A, Murad MH, Karmacharya P (2023) All-cause and cause-specific mortality in psoriatic arthritis and ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 75(5):1052–1065PubMed
18.
Mok CC, Kwok CL, Ho LY, Chan PT, Yip SF (2011) Life expectancy, standardized mortality ratios, and causes of death in six rheumatic diseases in Hong Kong. China Arthritis Rheum 63(5):1182–1189PubMed
19.
Exarchou S, Lie E, Lindström U, Askling J, Forsblad-d’Elia H, Turesson C et al (2016) Mortality in ankylosing spondylitis: results from a nationwide population-based study. Ann Rheum Dis. 75(8):1466–72PubMed
20.
Haroon NN, Paterson JM, Li P, Inman RD, Haroon N (2015) Patients with ankylosing spondylitis have increased cardiovascular and cerebrovascular mortality: a population-based study. Ann Intern Med 163(6):409–416PubMed
21.
Bhagavathula AS, Bentley BL, Woolf B, Dissanayaka TD, Rahmani J (2023) Increased risk of stroke among patients with ankylosing spondylitis: a systematic review and meta-analysis. Reumatol Clin 19(3):136–142PubMed
22.
Lee KS, Kronbichler A, Eisenhut M, Lee KH, Shin JI (2018) Cardiovascular involvement in systemic rheumatic diseases: an integrated view for the treating physicians. Autoimmun Rev 17(3):201–214PubMed
23.
González Mazón I, Rueda-Gotor J, Ferraz-Amaro I, Genre F, Corrales A, Calvo Rio V et al (2021) Subclinical atherosclerotic disease in ankylosing spondylitis and non-radiographic axial spondyloarthritis. A multicenter study on 806 patients. Semin Arthritis Rheum. 51(2):395–403PubMed
24.
Arida A, Protogerou AD, Konstantonis G, Konsta M, Delicha EM, Kitas GD et al (2015) Subclinical atherosclerosis is not accelerated in patients with ankylosing spondylitis with low disease activity: new data and metaanalysis of published studies. J Rheumatol 42(11):2098–2105PubMed
25.
Navarini L, Currado D, Marino A, Di Donato S, Biaggi A, Caso F et al (2022) Persistence of C-reactive protein increased levels and high disease activity are predictors of cardiovascular disease in patients with axial spondyloarthritis. Sci Rep 12(1):7498PubMedPubMedCentral
26.
Aicha BT, Ahmed F, Seif B, Ines M, Leila R, Selma B et al (2023) Spinal radiographic progression is correlated with preclinical atherosclerosis in spondyloarthritis. J Back Musculoskelet Rehabil 36(3):701–708PubMed
27.
Ferraz-Amaro I, Genre F, Blanco R, Corrales A, Mazón IG, Portilla V et al (2023) Sex differences in cardiovascular and disease-related features in axial spondyloarthritis. A multicenter study of 912 patients. Semin Arthritis Rheum. 60:152198PubMed
28.
Yuan Y, Yang J, Zhang X, Han R, Chen M, Hu X et al (2019) Carotid intima-media thickness in patients with ankylosing spondylitis: a systematic review and updated meta-analysis. J Atheroscler Thromb 26(3):260–271PubMedPubMedCentral
29.
Ozdowska P, Wardziak Ł, Kruk M, Kępka C, Kowalik I, Szwed H et al (2018) Increased prevalence of subclinical coronary atherosclerosis in young patients with ankylosing spondylitis. Pol Arch Intern Med 128(7–8):455–461PubMed
30.
Genre F, Rueda-Gotor J, Remuzgo-Martínez S, Pulito-Cueto V, Corrales A, Mijares V et al (2020) Omentin: a biomarker of cardiovascular risk in individuals with axial spondyloarthritis. Sci Rep 10(1):9636PubMedPubMedCentral
31.
Bonek K, Kuca-Warnawin E, Kornatka A, Zielińska A, Wisłowska M, Kontny E et al (2022) Associations of IL-18 with altered cardiovascular risk profile in psoriatic arthritis and ankylosing spondylitis. J Clin Med 11(3):766PubMedPubMedCentral
32.
Robert M, Miossec P, Hot A (2022) The Th17 pathway in vascular inflammation: culprit or consort? Front Immunol 13:888763PubMedPubMedCentral
33.
Han C, Robinson DW Jr, Hackett MV, Paramore LC, Fraeman KH, Bala MV (2006) Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol 33(11):2167–2172PubMed
34.
Ullensvang G, Kringeland E, Ikdahl E, Provan S, Berg IJ, Rollefstad S et al (2023) Cardiovascular organ damage in relation to hypertension status in patients with ankylosing spondylitis. Blood Press 32(1):2205956PubMed
35.
Shi LH, Lam SH, So H, Chan CY, Li TK, Szeto CC et al (2023) Inflammation is associated with incident hypertension in patients with axial spondyloarthritis: a longitudinal cohort study. Clin Exp Hypertens 45(1):2205056PubMed
36.
Chou CH, Lin MC, Peng CL, Wu YC, Sung FC, Kao CH et al (2014) A nationwide population-based retrospective cohort study: increased risk of acute coronary syndrome in patients with ankylosing spondylitis. Scand J Rheumatol 43(2):132–136PubMed
37.
Feng KM, Chien WC, Chen YH, Sun CA, Chung CH, Chen JT et al (2022) Increased risk of acute coronary syndrome in ankylosing spondylitis patients with uveitis: a population-based cohort study. Front Immunol 13:890543PubMedPubMedCentral
38.
Chen CH, Chen HA, Liao HT, Chou CT, Chen CH (2022) Association of blood pressure and hypertension with radiographic damage among the patients with ankyloing spondylitis. Medicine 101(38):e30811PubMedPubMedCentral
39.
Derakhshan MH, Goodson NJ, Packham JC, Sengupta R, Molto A, Marzo-Ortega H et al (2019) Increased risk of hypertension associated with spondyloarthritis disease duration: results from the ASAS-COMOSPA study. J Rheumatol 46(7):701–709PubMed
40.
Bartoloni E, Alunno A, Gerli R (2018) Hypertension as a cardiovascular risk factor in autoimmune rheumatic diseases. Nat Rev Cardiol 15(1):33–44PubMed
41.
Ozdowska P, Kowalik I, Sadowski K, Szwed H, Głuszko P, Rupiński R et al (2021) Patterns of dyslipidemia in young patients with seronegative spondyloarthropathies without cardiovascular diseases. Reumatologia 59(5):285–291PubMedPubMedCentral
42.
Hassan S, Milman U, Feld J, Eder L, Lavi I, Cohen S et al (2016) Effects of anti-TNF-α treatment on lipid profile in rheumatic diseases: an analytical cohort study. Arthritis Res Ther 18(1):261PubMedPubMedCentral
43.
Min HK, Lee J, Ju JH, Park SH, Kwok SK (2020) Impact of TNF-α inhibitor on lipid profile and atherogenic index of plasma in axial spondyloarthritis: 2-year follow-up data from the Catholic Axial Spondyloarthritis COhort (CASCO). Clin Rheumatol 39(2):471–477PubMed
44.
Masi AT, Fessler SL, Brezka ML, Wang Y, Donohue SE (2023) Systematic review and meta-analysis of individual serum lipids and analysis of lipid ratios in ankylosing spondylitis and healthy control cohorts: significantly lower mean HDL-cholesterol level in ankylosing spondylitis cohorts. Clin Exp Rheumatol. https://​doi.​org/​10.​55563/​clinexprheumatol​/​gtcard
45.
Kwon OC, Han K, Chun J, Kim R, Hong SW, Kim JH et al (2022) Effects of immune-mediated inflammatory diseases on cardiovascular diseases in patients with type 2 diabetes: a nationwide population-based study. Sci Rep 12(1):11548PubMedPubMedCentral
46.
Papadakis JA, Sidiropoulos PI, Karvounaris SA, Vrentzos GE, Spanakis EK, Ganotakis ES et al (2009) High prevalence of metabolic syndrome and cardiovascular risk factors in men with ankylosing spondylitis on anti-TNFalpha treatment: correlation with disease activity. Clin Exp Rheumatol 27(2):292–298PubMed
47.
Hokstad I, Greco D, Deyab G, Fagerland MW, Agewall S, Hjeltnes G et al (2022) Effects of antirheumatic treatment on cell cholesterol efflux and loading capacity of serum lipoproteins in spondylarthropathies. J Clin Med 11(24):7330PubMedPubMedCentral
48.
Slouma M, Ben Ali K, Kharrat L, Zouaoui C, Ouertani H, Gharsallah I (2022) Athrogenic indexes: useful markers for predicting metabolic syndrome in axial spondyloarthritis. Clin Investig Arterioscler 34(5):261–268PubMed
49.
Almasi S, Farahani B, Samiei N, Rezaei Y, Mahmoodi H, Qorbani M (2020) Echocardiographic and electrocardiographic findings in patients with ankylosing spondylitis without cardiovascular risk factors. J Tehran Heart Cent 15(2):43–49PubMedPubMedCentral
50.
Gartshteyn Y, Bhave N, Joseph MS, Askanase A, Bernstein E (2023) Inflammatory and thrombotic valvulopathies in autoimmune disease. Heart 109(8):583–588PubMed
51.
52.
Bengtsson K, Forsblad-d’Elia H, Lie E, Klingberg E, Dehlin M, Exarchou S et al (2018) Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with general population: a register-based study from Sweden. Ann Rheum Dis. 77(4):541–8PubMed
53.
Baniaamam M, Heslinga SC, Konings TC, Handoko ML, Kamp O, van Halm VP et al (2022) Aortic root diameter is associated with HLA-B27: identifying the patient with ankylosing spondylitis at risk for aortic valve regurgitation. Rheumatol Int 42(4):683–688PubMed
54.
Chetrit M, Khan MA, Kapadia S (2020) State of the art management of aortic valve disease in ankylosing spondylitis. Curr Rheumatol Rep 22(6):23PubMed
55.
Klingberg E, Sveälv BG, Täng MS, Bech-Hanssen O, Forsblad-d’Elia H, Bergfeldt L (2015) Aortic regurgitation is common in ankylosing spondylitis: time for routine echocardiography evaluation? Am J Med 128(11):1244–50.e1PubMed
56.
Min HK, Kim HR, Lee SH, Park S, Park M, Hong YS et al (2022) Increased risks of aortic regurgitation and atrial fibrillation in radiographic axial spondyloarthritis patients: a 10-year nationwide cohort study. Ther Adv Musculoskelet Dis 14:1759720X221088094
57.
Brunner F, Kunz A, Weber U, Kissling R (2006) Ankylosing spondylitis and heart abnormalities: do cardiac conduction disorders, valve regurgitation and diastolic dysfunction occur more often in male patients with diagnosed ankylosing spondylitis for over 15 years than in the normal population? Clin Rheumatol 25(1):24–29PubMed
58.
Moon I, Choi EK, Jung JH, Han KD, Choi YJ, Park J et al (2019) Ankylosing spondylitis: a novel risk factor for atrial fibrillation — a nationwide population-based study. Int J Cardiol 275:77–82PubMed
59.
Tilly MJ, Geurts S, Zhu F, Bos MM, Ikram MA, de Maat MPM et al (2023) Autoimmune diseases and new-onset atrial fibrillation: a UK Biobank study. Europace 25(3):804–811PubMed
60.
Gawałko M, Balsam P, Lodziński P, Grabowski M, Krzowski B, Opolski G et al (2020) Cardiac arrhythmias in autoimmune diseases. Circ J 84(5):685–694PubMed
61.
Ho HH, Yeh SJ, Tsai WP, Wang CM, Chen JY (2012) Paroxysmal supraventricular tachycardia and Wolff-Parkinson-White syndrome in ankylosing spondylitis: a large cohort observation study and literature review. Semin Arthritis Rheum 42(3):246–253PubMed
62.
Candemir M, Candemir B, Ertürk A (2020) Evaluation of cardiac autonomic nervous system in patients with ankylosing spondylitis using 12-lead electrocardiography and Holter monitoring. Clin Rheumatol 39(9):2631–2639PubMed
63.
Acar G, Yorgun H, Inci MF, Akkoyun M, Bakan B, Nacar AB et al (2014) Evaluation of Tp-e interval and Tp-e/QT ratio in patients with ankylosing spondylitis. Mod Rheumatol 24(2):327–330PubMed
64.
Bengtsson K, Klingberg E, Deminger A, Wallberg H, Jacobsson LTH, Bergfeldt L et al (2019) Cardiac conduction disturbances in patients with ankylosing spondylitis: results from a 5-year follow-up cohort study. RMD Open 5(2):e001053PubMedPubMedCentral
65.
Lange U, Stapfer G, Ditting T, Geiger H, Teichmann J, Müller-Ladner U et al (2007) Pathologic alterations of the heart and the kidney in patients with ankylosing spondylitis. Eur J Med Res 12(12):573–581PubMed
66.
Chen Y, Chan YH, Chung HY, Wu MZ, Yu YJ, Pi KL et al (2020) Cardiovascular events prediction by left ventricular longitudinal strain and serum high-sensitivity troponin I in patients with axial spondyloarthritis. Clin Rheumatol 39(11):3373–3382PubMed
67.
Chen Y, Chung HY, Zhao CT, Wong A, Zhen Z, Tsang HH et al (2015) Left ventricular myocardial dysfunction and premature atherosclerosis in patients with axial spondyloarthritis. Rheumatology 54(2):292–301PubMed
68.
Emren SV, Gerçik O, Özdemir E, Solmaz D, Eren N, Şimşek E et al (2020) Evaluation of subclinical myocardial dysfunction using speckle tracking echocardiography in patients with radiographic and non-radiographic axial spondyloarthritis. Eur J Rheumatol 7(1):9–15PubMed
69.
Lin TY, Lai YF, Chien WC, Chen YH, Chung CH, Chen JT et al (2023) Impact of endophthalmitis on the risk of acute myocardial infarction in ankylosing spondylitis patients: a population-based retrospective cohort study. J Clin Med 12(3):1211PubMedPubMedCentral
70.
Gan FY, Fei YY, Li MT, Wang Q, Xu D, Hou Y et al (2014) The characteristics of patients having ankylosing spondylitis associated with Takayasu’s arteritis. Clin Rheumatol 33(3):355–358PubMed
71.
Ernst D, Bearlecken N, Ernst Schmidt R, Witte T (2016) Two subsets of large vessel vasculitis characterized by the absence or presence of spondyloarthritis or its associated diseases. Open Rheumatol J 10:101–108PubMedPubMedCentral
72.
Ernst D, Baerlecken NT, Schmidt RE, Witte T (2014) Large vessel vasculitis and spondyloarthritis: coincidence or associated diseases? Scand J Rheumatol 43(3):246–248PubMed
73.
Ernst D, Bearlecken N, Schmidt RE, Witte T (2016) Two subsets of large vessel vasculitis characterized by the absence or presence of spondyloarthritis or its associated diseases. Open Rheumatol J 10:101–108PubMedPubMedCentral
74.
Eshed I, Druyan A, Stern M, Bordavka M, Lidar M (2022) The prevalence of sacroiliitis on abdominal MRI examinations of patients with Takayasu arteritis. Acta Radiol 63(3):387–392PubMed
75.
Kwon OC, Lee SW, Park YB, Oh JS, Lee SH, Hong S et al (2018) Extravascular manifestations of Takayasu arteritis: focusing on the features shared with spondyloarthritis. Arthritis Res Ther 20(1):142PubMedPubMedCentral
76.
Agüero F, González-Zobl G, Baena-Díez JM, Dégano IR, Garcia-Gil M, Alzamora MT et al (2015) Prevalence of lower extremity peripheral arterial disease in individuals with chronic immune mediated inflammatory disorders. Atherosclerosis 242(1):1–7PubMed
77.
Gwinnutt JM, Wieczorek M, Balanescu A, Bischoff-Ferrari HA, Boonen A, Cavalli G et al (2023) 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases. Ann Rheum Dis 82(1):48–56PubMed
78.
Passalent LA, Soever LJ, O’Shea FD, Inman RD (2010) Exercise in ankylosing spondylitis: discrepancies between recommendations and reality. J Rheumatol 37(4):835–841PubMed
79.
Halvorsen S, Vøllestad NK, Fongen C, Provan SA, Semb AG, Hagen KB et al (2012) Physical fitness in patients with ankylosing spondylitis: comparison with population controls. Phys Ther 92(2):298–309PubMed
80.
Sveaas SH, Berg IJ, Provan SA, Semb AG, Hagen KB, Vøllestad N et al (2014) Efficacy of high intensity exercise on disease activity and cardiovascular risk in active axial spondyloarthritis: a randomized controlled pilot study. PLoS One 9(9):e108688PubMedPubMedCentral
81.
Berg IJ, Semb AG, Sveaas SH, Fongen C, van der Heijde D, Kvien TK et al (2018) Associations between cardiorespiratory fitness and arterial stiffness in ankylosing spondylitis: a cross-sectional study. J Rheumatol 45(11):1522–1525PubMed
82.
Singh J, Tekur P, Metri KG, Mohanty S, Singh A, Nagaratna R (2021) Potential role of Yoga in the management of ankylosing spondylitis: a retrospective study. Ann Neurosci 28(1–2):74–78PubMedPubMedCentral
83.
Kaan U, Ferda O (2005) Evaluation of clinical activity and functional impairment in smokers with ankylosing spondylitis. Rheumatol Int 25(5):357–360PubMed
84.
Sakellariou GT, Anastasilakis AD, Kenanidis E, Potoupnis M, Tsiridis E, Savvidis M et al (2015) The effect of smoking on clinical and radiographic variables, and acute phase reactants in patients with ankylosing spondylitis. Rheumatol Int 35(12):2109–2114PubMed
85.
Zhao SS, Goodson NJ, Robertson S, Gaffney K (2020) Smoking in spondyloarthritis: unravelling the complexities. Rheumatology 59(7):1472–1481PubMed
86.
Ciaffi J, Mitselman D, Mancarella L, Brusi V, Lisi L, Ruscitti P et al (2021) The effect of ketogenic diet on inflammatory arthritis and cardiovascular health in rheumatic conditions: a mini review. Front Med 8:792846
87.
Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M et al (2022) 2021 ESC guidelines on cardiovascular disease prevention in clinical practice. G Ital Cardiol 23(6 Suppl 1):e3–e115
88.
Garg N, Krishan P, Syngle A (2015) Rosuvastatin improves endothelial dysfunction in ankylosing spondylitis. Clin Rheumatol 34(6):1065–1071PubMed
89.
Syngle A, Vohra K, Khichi D, Garg N, Verma I, Kaur L (2013) Spironolactone improves endothelial dysfunction in ankylosing spondylitis. Clin Rheumatol 32(7):1029–1036PubMed
90.
Garg N, Krishan P, Syngle A (2021) Angiotensin-receptor blockade improves inflammation and endothelial dysfunction in ankylosing spondylitis: ARB-AS study. Int J Angiol 30(4):262–270PubMedPubMedCentral
91.
Rollefstad S, Ikdahl E, Hisdal J, Olsen IC, Holme I, Hammer HB et al (2015) Rosuvastatin-induced carotid plaque regression in patients with inflammatory joint diseases: the rosuvastatin in rheumatoid arthritis, ankylosing spondylitis and other inflammatory joint diseases study. Arthritis Rheumatol 67(7):1718–1728PubMed
92.
Oza A, Lu N, Schoenfeld SR, Fisher MC, Dubreuil M, Rai SK et al (2017) Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study. Ann Rheum Dis 76(10):1737–1742PubMed
93.
Angel K, Provan SA, Fagerhol MK, Mowinckel P, Kvien TK, Atar D (2012) Effect of 1-year anti-TNF-α therapy on aortic stiffness, carotid atherosclerosis, and calprotectin in inflammatory arthropathies: a controlled study. Am J Hypertens 25(6):644–650PubMedPubMedCentral
94.
Végh E, Kerekes G, Pusztai A, Hamar A, Szamosi S, Váncsa A et al (2020) Effects of 1-year anti-TNF-α therapy on vascular function in rheumatoid arthritis and ankylosing spondylitis. Rheumatol Int 40(3):427–436PubMed
95.
Knyazeva LA, Damjanov N, Knyazeva LI, Meshcherina NS, Goryainov II, Stepchenko MA et al (2019) Effect of golimumab on endothelial vasomotor function and arterial stiffness in ankylosing spondylitis. Nauchno-Prakticheskaya Revmatologiya 57(3):312–317
96.
Syngle A, Vohra K, Sharma A, Kaur L (2010) Endothelial dysfunction in ankylosing spondylitis improves after tumor necrosis factor-alpha blockade. Clin Rheumatol 29(7):763–770PubMed
97.
Tam LS, Shang Q, Kun EW, Lee KL, Yip ML, Li M et al (2014) The effects of golimumab on subclinical atherosclerosis and arterial stiffness in ankylosing spondylitis-a randomized, placebo-controlled pilot trial. Rheumatology 53(6):1065–1074PubMed
98.
Angel K, Provan SA, Hammer HB, Mowinckel P, Kvien TK, Atar D (2011) Changes in arterial stiffness during continued infliximab treatment in patients with inflammatory arthropathies. Fundam Clin Pharmacol 25(4):511–517PubMed
99.
Mathieu S, Pereira B, Couderc M, Rabois E, Dubost J, Soubrier M (2013) No significant changes in arterial stiffness in patients with ankylosing spondylitis after tumour necrosis factor alpha blockade treatment for 6 and 12 months. Rheumatology 52(1):204–209PubMed
100.
Genre F, López-Mejías R, Miranda-Filloy JA, Ubilla B, Mijares V, Carnero-López B et al (2015) Anti-TNF-α therapy reduces endothelial cell activation in non-diabetic ankylosing spondylitis patients. Rheumatol Int 35(12):2069–2078PubMed
101.
Mathieu S, Dubost JJ, Tournadre A, Malochet-Guinamand S, Ristori JM, Soubrier M (2010) Effects of 14 weeks of TNF alpha blockade treatment on lipid profile in ankylosing spondylitis. Joint Bone Spine 77(1):50–52PubMed
102.
van Eijk IC, de Vries MK, Levels JH, Peters MJ, Huizer EE, Dijkmans BA et al (2009) Improvement of lipid profile is accompanied by atheroprotective alterations in high-density lipoprotein composition upon tumor necrosis factor blockade: a prospective cohort study in ankylosing spondylitis. Arthritis Rheum 60(5):1324–1330PubMed
103.
Ersozlu Bozkirli ED, Bozkirli E, Yucel AE (2014) Effects of infliximab treatment in terms of cardiovascular risk and insulin resistance in ankylosing spondylitis patients. Mod Rheumatol 24(2):335–339PubMed
104.
Kiortsis DN, Mavridis AK, Filippatos TD, Vasakos S, Nikas SN, Drosos AA (2006) Effects of infliximab treatment on lipoprotein profile in patients with rheumatoid arthritis and ankylosing spondylitis. J Rheumatol 33(5):921–923PubMed
105.
Bhala N, Emberson J, Merhi A, Abramson S, Arber N, Baron JA et al (2013) Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet 382(9894):769–779PubMed
106.
Trelle S, Reichenbach S, Wandel S, Hildebrand P, Tschannen B, Villiger PM et al (2011) Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ 342:c7086PubMedPubMedCentral
107.
Karmacharya P, Shahukhal R, Crowson CS, Murad MH, Davis JM 3rd, Shrestha P et al (2020) Effects of therapies on cardiovascular events in ankylosing spondylitis: a systematic review and meta-analysis. Rheumatol Ther 7(4):993–1009PubMedPubMedCentral
108.
109.
Braun J, Baraliakos X, Westhoff T (2020) Nonsteroidal anti-inflammatory drugs and cardiovascular risk - a matter of indication. Semin Arthritis Rheum 50(2):285–288PubMed
110.
So H, Tam LS (2022) Nonsteroidal anti-inflammatory drugs and cardiovascular disease risk in spondyloarthritis-spectrum diseases. Curr Opin Rheumatol 34(4):203–208PubMed
111.
Tam HW, Yeo KJ, Leong PY, Chen CH, Li YC, Ma CM et al (2017) Sulfasalazine might reduce risk of cardiovascular diseases in patients with ankylosing spondylitis: a nationwide population-based retrospective cohort study. Int J Rheum Dis 20(3):363–370PubMed
112.
Wu LC, Leong PY, Yeo KJ, Li TY, Wang YH, Chiou JY et al (2016) Celecoxib and sulfasalazine had negative association with coronary artery diseases in patients with ankylosing spondylitis: a nation-wide, population-based case-control study. Medicine 95(36):e4792PubMedPubMedCentral
113.
Chan SCW, Teo CK, Li PH, Lau KK, Lau CS, Chung HY (2021) Cardiovascular risk in patients with spondyloarthritis and association with anti-TNF drugs. Ther Adv Musculoskelet Dis. 13:1759720x211032444PubMedPubMedCentral
114.
Lee JL, Sinnathurai P, Buchbinder R, Hill C, Lassere M, March L (2018) Biologics and cardiovascular events in inflammatory arthritis: a prospective national cohort study. Arthritis Res Ther 20(1):171PubMedPubMedCentral
115.
Kwon OC, Park MC (2022) Effect of tumor necrosis factor inhibitors on risk of cardiovascular disease in patients with axial spondyloarthritis. Arthritis Res Ther 24(1):141PubMedPubMedCentral
116.
Singh JA (2022) Risks and benefits of Janus kinase inhibitors in rheumatoid arthritis - past, present, and future. N Engl J Med 386(4):387–389PubMed
117.
Ytterberg SR, Bhatt DL, Mikuls TR, Koch GG, Fleischmann R, Rivas JL et al (2022) Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N Engl J Med 386(4):316–326PubMed
118.
Smolen JS, Landewé RBM, Bergstra SA, Kerschbaumer A, Sepriano A, Aletaha D et al (2023) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis 82(1):3–18PubMed
119.
Ramiro S, Nikiphorou E, Sepriano A, Ortolan A, Webers C, Baraliakos X et al (2023) ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis 82(1):19–34PubMed
120.
Makris A, Barkas F, Sfikakis PP, Liberopoulos E, Agouridis AP (2022) The effect of upadacitinib on lipid profile and cardiovascular events: a meta-analysis of randomized controlled trials. J Clin Med 11(23):6894PubMedPubMedCentral
121.
Evangelatos G, Fragoulis GE (2023) JAK inhibitors, cardiovascular and thromboembolic events: what we know and what we would like to know. Clin Rheumatol 42(3):959–962PubMed
Metadata
Title
Cardiovascular risk in axial spondyloarthritis—a systematic review
Authors
Rainer Hintenberger
Barbara Affenzeller
Valeriia Vladychuk
Herwig Pieringer
Publication date
07-07-2023
Publisher
Springer International Publishing
Published in
Clinical Rheumatology / Issue 10/2023
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-023-06655-z

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