Hulander Erik, Deminger Anna, Enegren Sofia, Hallström Magnus, Feldthusen Caroline, Fagman Erika, Angerås Oskar, Zverkova Sandström Tatiana, Geijer Mats, Forsblad-d'Elia Helena
Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.
Clinical Nutrition Unit, Region Västra Götaland, Sahlgrenska University Hospital, 43145 Gothenburg, Sweden.
J Cardiovasc Dev Dis. 2025 Aug 12;12(8):305. doi: 10.3390/jcdd12080305.
Radiographic axial spondyloarthritis (r-axSpA) is associated with increased cardiovascular disease (CVD) risk. The coronary artery calcification (CAC) score, an atherosclerosis burden indicator that predicts CVD risk, is not well studied in r-axSpA. This study investigates CAC scores in patients with r-axSpA compared to controls without rheumatic disease and factors associated with CAC scores in r-axSpA patients. Fifty-eight r-axSpA patients from southwestern Sweden were assessed cross-sectionally using clinical disease measures, physical function, spinal mobility, lipid profiles, inflammation markers, and long-term time-averaged C-reactive protein (CRP). Four controls per patient were selected from the Swedish CArdioPulmonary bioImage Study (SCAPIS). CAC was scored on cardiac computed tomography (CT) using the Agatston method. The presence of CAC in the right coronary artery (RCA) was higher in patients compared to controls. However, no significant difference in total CAC scores was observed between r-axSpA patients and controls, despite numerically higher total CAC scores in patients. In r-axSpA patients, CAC scores correlated positively with time-averaged CRP, reduced physical function, and impaired spinal mobility. These findings suggest that chronic inflammation may contribute to coronary calcification and CVD risk in r-axSpA, highlighting the need for effective anti-inflammatory treatments. Further research is warranted to explore the association between coronary calcification, spinal immobility, and limitations in physical function.
影像学轴向性脊柱关节炎（r-axSpA）与心血管疾病（CVD）风险增加相关。冠状动脉钙化（CAC）评分是一种预测CVD风险的动脉粥样硬化负担指标，在r-axSpA中尚未得到充分研究。本研究调查了r-axSpA患者与无风湿性疾病的对照组相比的CAC评分，以及r-axSpA患者中与CAC评分相关的因素。对瑞典西南部的58例r-axSpA患者进行了横断面评估，采用临床疾病测量、身体功能、脊柱活动度、血脂谱、炎症标志物和长期时间平均C反应蛋白（CRP）。从瑞典心肺生物图像研究（SCAPIS）中为每位患者选择4名对照。使用阿加斯顿方法在心脏计算机断层扫描（CT）上对CAC进行评分。与对照组相比，患者右冠状动脉（RCA）中CAC的存在率更高。然而，尽管患者的总CAC评分在数值上更高，但r-axSpA患者与对照组之间在总CAC评分上未观察到显著差异。在r-axSpA患者中，CAC评分与时间平均CRP、身体功能降低和脊柱活动度受损呈正相关。这些发现表明，慢性炎症可能导致r-axSpA中的冠状动脉钙化和CVD风险，凸显了有效抗炎治疗的必要性。有必要进一步研究以探讨冠状动脉钙化、脊柱活动受限和身体功能障碍之间的关联。
