DYSLIPIDEMIA IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS AS A RISK FACTOR FOR ISCHEMIC HEART DISEASE
Summary. To date, there is evidence of the relationship between rheumatic diseases and cardiovascular pathology, which is based on manifestations of systemic inflammation, which cause the progression of the atherosclerotic process, including in the coronary arteries. The aim of the study was to determine the features of the lipid profile in patients with axial spondyloarthritis and their impact on the incidence of coronary heart disease. Materials and methods. A retrospective analysis of the medical records of 51 male patients with axial spondyloarthritis (AxSpA) with existing comorbid pathology of the cardiac profile was conducted, the control group consisted of 140 male patients without rheumatological pathology who were hospitalized for a cardiac diagnosis. In both groups, the lipid profile was analyzed, the frequency of coronary heart disease (CHD), angina symptoms, the frequency of non-fatal cardiovascular events — myocardial infarctions and strokes, the frequency of hospitalizations for worsening CHD, as well as the frequency of concomitant pathology: obesity, type II diabetes mellitus, hypertension. Results. It was found that in patients with AxSpA, compared with the control group, there was a 14.5% higher level of total cholesterol, a 22.2% higher content of low-density lipoprotein cholesterol, and a 29.2% higher atherogenic index. The concentration of C-reactive protein in patients with AxSpA compared with the control group was 43.6% higher (p < 0.01). In patients with AxSpA, a diagnosis of CHD was one and a half times more often compared with the control group and angina pectoris symptoms were more often registered, patients with AxSpA also needed hospitalization for CHD more often, in addition, dyslipidemia was 1.4 times more often detected among patients with AxSpA. The frequency of cardiovascular events, the presence of obesity, hypertension, and type 2 diabetes mellitus did not differ significantly. Conclusions. In patients with axial spondyloarthritis, multivariate regression analysis identified factors that have a significant impact on the development of ischemic heart disease: duration of axial spondyloarthritis ≥ 10 years; activity of axial spondyloarthritis according to BASDAI ≥ 5.0 points; C-reactive protein content ≥ 9.0 mg/ml; low-density lipoprotein cholesterol content ≥ 4.0 mmol/l; atherogenic index ≥ 5.0 conv. units; presence of type II diabetes mellitus.
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