Radiographic structural damage predicted increased epicardial adipose tissue thickness in Spondyloarthritis

Introduction: There is a growing interest in the role of epicardial adipose tissue (EAT) as a novel marker of subclinical coronary atherosclerosis. We aimed to assess EAT thickness in spondyloarthritis (SpA) patients compared with healthy controls and to identify its predictive factors.Methods: This was a cross-sectional study including SpA patients and age and gender-matched healthy volunteers without traditional cardiovascular risk factors. General and biological data were obtained for all participants. Disease characteristics and therapeutic modalities were recorded at the time of inclusion. Both patients and control groups underwent echocardiography with measurement of EAT thickness. Results: A total of 47 SpA patients and 47 healthy controls were included, with a median age of 36 years and a sex-ratio of 2.35.Ultrasound EAT thickness was significantly increased in SpA patients compared with healthy controls (median value of 3.1 mm versus 2.4 mm; p=0.001). EAT thickness was positively correlated with patient-related parameters (age, systolic blood pressure, triglyceride level). Regarding disease-related characteristics, EAT thickness was positively correlated to age at onset of SpA and negatively correlated to chest expansion. Moreover, EAT thickness was significantly associated with radiographic structural damage (syndesmophytes, bony bridging, facet joint arthritis, and mSASSS score). In multivariate linear regression, age at onset of SpA, triglyceride level, and mSASSS were identified as the independent predictive factors of increased EAT thickness in SpA.Conclusion: SpA patients exhibited significantly more subclinical coronary atherosclerosis than controls. EAT thickness was independently associated with mSASSS score supporting the role of the inflammatory process in cardiovascular risk.