Subclinical atherosclerosis: A hidden threat for patients with ankylosing spondylitis

In the current study entitled “Assessment of subclinical atherosclerotic cardiovascular disease in patients with ankylosing spondylitis” Anatol J Cardiol 2019; 22: 185-91, Hatipsoylu et al. (1), authors have failed to demonstrate the relationship between AS and atherosclerosis progression. Nevertheless, it was a study in which some main traditional risk factors for CVD were controlled. Two noninvasive techniques were used, carotid intima media thickness (cIMT) and pulse wave velocity, which were considered as important indicators for evaluating the severity of atherosclerotic intimal lesions and arterial stiffness; however, these two instruments cannot assess endothelial function. It is possible to compare the vascular function outputs of different instruments (2). However, further research is needed to confirm the relation of endothelial dysfunction and/or arterial stiffness assessed non-invasively with the atherosclerotic process in patients with AS (2-5). In fact, the relationship between atheroscolerosis and AS is not as easy to highlight, as in rheumatoid arthritis (6).