Hyperlipoproteinaemia (a) in patients with spondyloarthritis: results of the Cardiovascular in Rheumatology (CARMA) project
García-Gómez, C.; Martín-Martínez, M.ía.A.; Fernández-Carballido, C.; Castañeda, S.; González-Juanatey, C.; Sanchez-Alonso, F.; González-Fernández, M.ía.J.; Sanmartí, R.; García-Vadillo, J.ús.A.; Fernández-Gutiérrez, B.ín.; García-Arias, M.; Manero, F.J.; Senabre, J.é M.; Rueda-Cid, A.; Ros-Expósito, S.; Pina-Salvador, J.é M.; Erra-Durán, A.; Möller-Parera, I.; Llorca, J.; González-Gay, M.A.
Clinical and Experimental Rheumatology 37(5): 774-782
2019
ISSN/ISBN: 0392-856X PMID: 30789151 Document Number: 697910
Cardiovascular (CV) disease is one of the main causes of morbi-mortality in spondyloarthritis (SpA), partially explained by traditional CV risk factors. Information on lipoprotein(a) [Lp(a)], a non-conventional risk factor, in SpA is scarce. In this study we assessed the prevalence of hyperlipoproteinaemia(a) in SpA patients and analysed the possible related factors. A baseline analysis was made of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients and controls included in the CARMA project (CARdiovascular in RheuMAtology), a 10-year prospective study evaluating the risk of CV events in chronic inflammatory rheumatic diseases. A multivariate logistic regression model was performed using hyperlipoproteinaemia(a) (Lp(a) >50 mg/dl) as a dependent variable and adjusting for confounding factors. 19.2% (95% CI: 16.80-22.05) of the SpA patients [20.7% (95% CI: 16.91-24.82) of those with AS and 17.7% (95% CI: 14.15-21.75) of those with PsA] and 16.7% (95% CI: 13.23-20.86) of the controls had hyperlipoproteinaemia(a) (p=0.326). Adjusting for age and sex, SpA patients were more likely to have hyperlipoproteinaemia(a) than controls (OR: 1.43, 95%CI: 1.00-2.04; p=0.05), especially those with AS (OR: 1.81, 95%CI: 1.18-2.77; p=0.007). In the adjusted model, apolipoprotein B in all patients, non-steroidal anti-inflammatory drugs in AS, and female sex in PsA, were associated with hyperlipoproteinaemia(a). No disease-specific factors associated with hyperlipoproteinaemia(a) were identified. SpA patients show a moderately increased risk of hyperlipoproteinaemia(a) compared to controls, especially those with AS. Lp(a) determination may be of interest to improve the CV risk assessment in SpA patients.