ABSTRACT
Objective: To explore the risk factors contributing to the development of premature coronary artery disease (PCAD) in patients with ankylosing spondylitis (AS) and assess the clinical implications of this association. Methods: The study used a retrospective analysis design to investigate the risk factors and clinical significance of ankylosing spondylitis (AS) combined with early-onset coronary heart disease (AS-PCAD). A total of 80 patients diagnosed with AS and coronary heart disease who were admitted to the hospital between February 2019 and February 2022 were included in the analysis. The patients were divided into two groups based on the age of onset of coronary heart disease - the PCAD group (n=42, mean age 41.48±2.69 years) and the non-early-onset coronary heart disease (NPCAD) group (n=38, mean age 69.13±4.50 years). Relevant clinical data, including demographics, medical history, laboratory results, and imaging findings, were extracted from electronic health records. Binary logistic regression analysis was employed to identify risk factors influencing the incidence of AS-PCAD. The study aimed to uncover the distinctive clinical features and risk factors associated with AS patients who experience early-onset coronary heart disease, in order to guide diagnosis and treatment strategies for this patient population. Results: The results of the study revealed several notable findings. Significant differences were observed between the PCAD and NPCAD groups in terms of age and age at AS onset (P < .05). Specifically, patients in the PCAD group had a younger mean age at AS onset compared to the NPCAD group (41.48±2.69 years vs 69.13±4.50 years, respectively). Additionally, the two groups exhibited statistically significant differences in several laboratory parameters. Levels of C-reactive protein (CRP) were found to be markedly higher in the PCAD group compared to the NPCAD group (P < .05). Hemoglobin levels and the prevalence of anemia also showed significant variations between the two cohorts (both P < .05). Importantly, the binary logistic regression analysis identified two key risk factors that independently influenced the incidence of PCAD in AS patients: younger age at AS onset and elevated levels of C-reactive protein. Conclusions: The key findings of this study underscore the heightened risk of premature coronary artery disease in patients with ankylosing spondylitis, particularly those with a younger age of AS onset and elevated levels of systemic inflammation as marked by C-reactive protein. These results have important clinical implications. Identifying AS patients at increased risk for PCAD, based on factors such as younger disease onset and higher inflammatory burden, enables targeted screening and early intervention strategies. Comprehensive cardiovascular risk assessment and management should be an integral part of the care approach for this patient population. Early recognition of PCAD risk, followed by aggressive management of modifiable risk factors and implementation of appropriate therapeutic measures, can help mitigate the burden of premature cardiovascular complications in individuals with ankylosing spondylitis.