A new study published in the Clinical Rheumatology aimed to identify the predictors of an accelerated subclinical atherosclerosis in patients with spondyloarthritis (SpA). Here, patients were evaluated at baseline and after 13.5 ± 3.6 months. Ultrasound measurements of carotid intima-media thickness (cIMT) and distensibility coefficient (cDC) were used to assess the extent of subclinical atherosclerosis. It was observed that, at baseline, the mean Framingham Risk Score was 14 ± 11%. At follow-up, cIMT increased in 39 patients. Mean cIMT progression rate was 0.01 mm/year. While cDC was unchanged at follow-up. Patients with accelerated atherosclerosis had significantly higher serum creatinine and lower glomerular filtration rate (eGFR) at baseline. Whereas, only eGFR and the presence of syndesmophytes were associated with an accelerated atherosclerosis, independent of traditional cardiovascular risk factors. Hence, it was concluded that in patients with SpA without overt CV disease, a decrease in renal function and radiographic damage are conditions associated with the development of subclinical accelerated atherosclerosis. Longitudinal assessment of cIMT was proposed to better evaluate the individual cardiovascular diseases (CVD) risk of these patients, improving their prognostic stratification.