Aortic calcification in patients with rheumatoid arthritis and ankylosing spondylitis: a cross-sectional case-control study

Abstract Objectives: Vascular calcification contributes to cardiovascular consequences in rheumatoid arthritis (RA) and ankylosing spondilytis (AS). This study was to evaluate the aortic calcification in RA and AS, and investigate possible risk factors. Methods: The in-patients with RA or AS were consecutively recruited from a general hospital. Control subjects were healthy population recruited from the same hospital. The aortic calcification score (ACS) was obtained by 256-slice spiral CT scanners using the Heart Beat-CS program (Philips Medical Systems, Cleveland Ohio, USA). Results: 146 RA patients, 97 AS patients and 200 controls were included. Serum triglyceride, cholesterol, urate, high and low density liptein cholesterols in RA or AS were all lower than that in controls. The ACS was higher in RA group than in AS and control groups. Only young (≤50 yrs) female AS had ACS higher than controls. Compared with the controls, RA increased the risk for aortic calcification by 4.72 (95% CI 2.78-7.99) fold after adjusted for age and sex. While AS in general, did not. Advanced age, male sex and elevated blood glucose were the risk factors for ACS in controls; advanced age, high C-reactive protein (CRP) and more co-morbidities were the risk factors in AS; and advanced age, long disease course, high DAS28(CRP) were risk factors in RA. Conclusions: Patients with RA or AS were more likely to develop aortic calcification compared with age and sex-matched healthy controls. Long disease course and high inflammatory criteria were risk factors, which advocate an intense control of disease associated systemic inflammation.