Research Article Carotid Intima Media Thickness as a Marker of Atherosclerosis in Ankylosing Spondylitis Naveen Gupta, 1 Renu Saigal, 2,3 Laxmikant Goyal, 1 Abhishek Agrawal, 1 Rajat Bhargava, 1 and Arun Agrawal 1 1 Department of Medicine, SMS Medical College, Jaipur, India 2 Department of Medicine, MG Medical College, Jaipur, India 3 Rheumatology Clinic, Mahatma Gandhi Medical College and Hospital, 33 Muktanand Nagar, Gopalpura Byepass, Lane in front of Amarnath Hospital, Jaipur 302018, India Correspondence should be addressed to Renu Saigal; saigalrenu53@gmail.com Received 20 January 2014; Revised 13 March 2014; Accepted 13 March 2014; Published 7 April 2014 Academic Editor: Luis R. Espinoza Copyright © 2014 Naveen Gupta et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aim. Increased cardiovascular morbidity and mortality have been observed in ankylosing spondylitis because of accelerated atherosclerosis. We measured carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in this study. Methods. In this study 37 cases of AS and the same number of matched individuals were recruited. CIMT measurements were done using B- mode ultrasound. Disease activity was assessed using Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. Results. Mean age of the study groups was 29.43 ± 9.00 years. Average disease duration was 65.62 ± 54.92 months. Twenty-eight (75.68%) of cases were HLA B-27 positive. A signiicantly increased CIMT was observed in cases as compared to control group (0.62 ± 0.12 versus 0.54 ± 0.04;  < 0.001). CIMT in the cases group positively correlated with age ( = 0.357;  < 0.05), duration of disease ( = 0.549;  < 0.01), and BASMI ( = 0.337;  < 0.05) and negatively correlated with ESR ( = −0.295;  < 0.05). Conclusions. Patients of AS had a higher CIMT than those of the control group. CIMT correlated with disease chronicity. 1. Introduction Ankylosing spondylitis (AS) is a chronic inlammatory dis- ease of the axial skeleton, also associated with peripheral arthritis and cardiac, ocular, and gastrointestinal manifesta- tions. Cardiovascular mortality has been found to be increased in rheumatic diseases, which is attributed to accelerated atherosclerosis [1, 2]. A wide range of cardiovascular features are associated with ankylosing spondylitis, namely, aortitis, aortic regurgitation, and conduction abnormalities [3, 4], along with an increased risk of atherosclerosis related car- diovascular events like myocardial infarction and stroke, leading to a signiicantly increased mortality [5, 6]. Chronic systemic inlammation is implicated as the driving force behind accelerated atherosclerosis in rheumatic diseases [7, 8]. Among the various screening methods, carotid intima media thickness (CIMT) has gained wide acceptance as a marker of atherosclerosis predicting future cardiovascular events [9, 10]. In this study we have compared CIMT in patients of AS with a matched group of healthy individuals. We also studied the correlation between CIMT and Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylos- ing spondylitis metrological index (BASMI) scores and C- reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and HLA B-27 status. 2. Methods hirty-seven patients were recruited from the rheumatology clinic at Sawai Man Singh Hospital, Jaipur, for the study.