Key result
Ankylosing spondylitis is associated with ~16% higher arterial stiffness despite preserved traditional CV risk.
Why the study?
Ankylosing spondylitis may cause early subclinical vascular damage not detected by traditional cardiovascular risk scores, necessitating evaluation of arterial stiffness and vascular impairment.
Is ankylosing spondylitis associated with increased arterial stiffness and early vascular damage compared to healthy controls regardless of traditional cardiovascular risk factors?
Cross-Sectional (n=114)
No
Is ankylosing spondylitis associated with increased arterial stiffness and early vascular damage compared to healthy controls regardless of traditional cardiovascular risk factors?
Absolute Event Rate: 7% vs 6.05%
p-value: p=<0.001
Ankylosing spondylitis is characterized by early functional vascular impairment and increased arterial stiffness despite preserved traditional cardiovascular risk profiles.
Findings should not yet alter CV risk stratification in ankylosing spondylitis; leaves open prognostic value of stiffness measures.
Background: Our aim is to evaluate subclinical vascular damage in patients with ankylosing spondylitis using one-point echo-tracking-derived arterial stiffness indices and carotid intima-media thickness (CIMT), and to explore associations with inflammatory activity and traditional cardiovascular risk scores. Methods: This cross-sectional study included 83 patients with AS and 31 age- and sex-matched controls without inflammatory or cardiovascular disease. All participants underwent high-resolution ultrasound of the common carotid artery with one-point echo-tracking assessment of arterial stiffness parameters, including β-stiffness index, local pulse wave velocity (PWVβ), Peterson's elastic modulus (Ep), arterial compliance, and augmentation index, alongside CIMT measurement. Ten-year cardiovascular risk was estimated using the Framingham Risk Score and SCORE2. Results: Traditional cardiovascular risk estimates were comparable between groups (Framingham risk: 3.7 [2.0-7.5]% vs 5.25 [2.5-8.0]%, p = 0.378; SCORE2: 6.7 [3.5-10.5]% vs 7.3 [3.0-11.0]%, p = 0.718). In contrast, patients with AS demonstrated significantly increased arterial stiffness, with higher β-stiffness index (7.0 [5.4-8.6] vs 6.05 [5.2-6.9], p < 0.001), PWVβ (5.8 [5.2-6.5] vs 5.45 [4.9-5.9] m/s, p < 0.001), and Ep (90 [68-112] vs 78.5 [66-90] kPa, p < 0.001). CIMT did not differ significantly between groups. Body mass index independently predicted arterial stiffness (PWVβ standardized β = 0.41, p < 0.001). Conclusions: Ankylosing spondylitis is characterised by early functional vascular impairment despite preserved traditional cardiovascular risk profiles. One-point echo-tracking-derived arterial stiffness indices identify subclinical vascular damage beyond conventional risk assessment and may improve cardiovascular risk stratification in AS.
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Markov et al. (2026) conducted a cross-sectional in Ankylosing spondylitis (n=114). Ankylosing spondylitis vs. Matched controls without inflammatory or cardiovascular disease was evaluated on β-stiffness index (p=<0.001). Ankylosing spondylitis was associated with significantly increased arterial stiffness, including a higher β-stiffness index (7.0 vs 6.05) and local pulse wave velocity (5.8 vs 5.45 m/s), despite preserved traditional cardiovascular risk profiles.
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