Frequency and features of cardiovascular diseases in spondyloarthritis

BACKGROUND: Group of spondyloarthritis include not only damage of musculoskeletal system, oftenly it’s combination with a variety of comorbid pathologies, primarily involving the cardiovascular system, is characteristic. Given the high importance of early detection, assessment and further prediction of the risks of cardiovascular diseases in this cohort of patients, a competent interpretation of the risks of aggravating cardiovascular diseases and their prevention is one of the priority tasks not only for rheumatologists, but also for specialists in related fields.

AIM: To study the structure of comorbid pathology and assess the frequency of cardiovascular diseases in patients with ankylosing spondylitis, psoriatic arthritis and psoriatic spondyloarthritis, to conduct a comparative analysis of the incidence of cardiovascular comorbidities in different groups of spondyloarthritis.

MATERIALS AND METHODS: The study included 153 patients with a verified diagnosis of spondyloarthritis. Patients were divided into 3 groups depending on the nature of the lesion of the musculoskeletal system: ankylosing spondylitis meeting the modified New York criteria for ankylosing spondylitis (1984) (n = 53), psoriatic arthritis meeting the CASPAR criteria (Classification criteria of Psoriatic Arthritis, 2006) (n = 40) and psoriatic spondylitis simultaneously meeting the modified New York criteria for ankylosing spondylitis and the CASPAR criteria for psoriatic arthritis (n = 60). All patients taken with monoclonal antibodies (inhibitors TNF-alpha).

RESULTS: When studying cardiovascular comorbidity in patients with spondyloarthritis in three groups, arterial hypertension was most common in the ankylosing spondylitis group — 37.7%, in psoriatic arthritis — 62.5%, in the psoriatic spondyloarthritis group — 51.7%, conduction disturbance in ankylosing spondylitis — 28, 3%, in psoriatic arthritis — 17.5%, in the psoriatic spondyloarthritis group — 18.3%, dyslipidemia is significantly more common in the psoriatic arthritis and psoriatic spondyloarthritis groups — 47.5% and 51.7%, respectively, compared with the ankylosing spondylitis group — 18.9%. Along with cardiovascular diseases, endocrine disorders were detected with a high frequency of occurrence: overweight was more common in patients of the psoriatic arthritis and psoriatic spondyloarthritis groups — 35.0 and 38.3%, respectively, significant differences in the incidence of type 2 diabetes mellitus in the three groups has not been identified.

CONCLUSIONS: It is necessary to carry out medical examination in order to identify comorbidities in patients with various forms of spondyloarthritis, in order to determine further tactics of management and correction, depending not only on the activity of the disease, but also taking into account comorbidities.