Clinical and subclinical atherosclerosis in systemic sclerosis: consequences of previous corticosteroid treatment

Vettori, Serena; Maresca, Lucio; Cuomo, Giovanna; Abbadessa, S; Leonardo, Giuseppe; Valentini, Gabriele

doi:10.3109/03009741003781985

Cited by 31 publications

(25 citation statements)

References 13 publications

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“…In contrast to the previous findings, other studies [25][26][27][28][29][30][31] found that the mean common carotid arteries IMT were not significantly increased compared with healthy controls. The differences between the results of the present study and the results of these studies may be due to the larger percentage of diffuse cutaneous SSc subtype in these studies compared with ours.…”

Section: Discussioncontrasting

confidence: 89%

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

Farag

Serougy

Metawee

et al. 2015

The Egyptian Rheumatologist

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Aim of the work: To measure the extent of subclinical atherosclerosis in patients with systemic sclerosis, and to evaluate any potential vascular risk factors in these patients.Patients and methods: This study included 30 patients with systemic sclerosis diagnosed according to the American college of rheumatology criteria and 20 healthy individuals were also included as a control group. Non-invasive vascular tests including; carotid duplex scanning measuring common carotid arteries (CCA) intima-media thickness (IMT), and ankle brachial pressure index (ABPI) were performed. Traditional vascular risk factors such as blood pressure, blood sugar, lipid profiles, steroid usage and other immunosuppressive medications were assessed.Results: The mean IMT of CCA was higher in systemic sclerosis patients (right 0.67 ± 0.11 mm, left 0.67 ± 0.12 mm) when compared with the control group (right 0.48 ± 0.2 mm, left 0.54 ± 0.13 mm) (p < 0.001). Carotid plaques were found in 4 SSc patients. Mean IMT was correlated with patients' age (p < 0.001), disease duration (p < 0.001), systolic blood pressure (p < 0.05), and dyslipidemia (p < 0.01). Ankle brachial pressure index (ABPI) was significantly lower in SSc patients (0.94 ± 0.13) when compared with controls (1.16 ± 0.12) (p < 0.001). No difference was found between limited (n = 25) and diffuse (n = 5) disease subtypes in mean IMT, nor in mean ABPI. There was no significant correlation between mean IMT and steroid dose or other immunosuppressive intake.Conclusion: There is an increased risk of subclinical atherosclerosis and peripheral arterial disease in SSc patients. Increased systolic blood pressure, dyslipidemia, long disease duration and older age were possible risk factors.

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Section: Discussioncontrasting

confidence: 89%

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

Farag

Serougy

Metawee

et al. 2015

The Egyptian Rheumatologist

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“…Our patients were younger than the patients in other published series where it has been shown that the disease mostly affects women in their 4th or 5th decade of life [4][5][17][18][19]. Limited cutaneous involvement was predominant, which was expected [4][5]20]. Though the mean duration of Raynaud's was more in dcSSc than lcSSc, this difference was not statistically significant (Table 5).…”

Section: Discussioncontrasting

confidence: 60%

“…Subclinical atherosclerosis has been reported in both SLE as well as RA in various studies [3]. There is increasing evidence that atherosclerosis occurs prematurely in systemic sclerosis [4][5][6]. Although micro vascular disease is characteristic of SSc, but there is growing evidence of macro vascular disease in SSc patients.…”

Section: Introductionmentioning

confidence: 99%

Carotid Intima Media Thickness in Systemic Sclerosis Patients: Results From a Single Centre, Cross Sectional, Case-Control Study

Sharma¹,

Mohamed²,

Prakash³

et al. 2017

Angiol

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Objective: To describe the parameters of subclinical vascular changes [Carotid Intima Media Thickness (cIMT), Flow Mediated Dilatation (FMD), Ankle Brachial Pressure Index (ABPI)] in patients with systemic sclerosis and compare them with age and sex matched controls.Methods: 50 patients of systemic sclerosis aged 20-50 years were selected and compared with the same no. of age and sex matched controls. Patients with diabetes, hypertension, dyslipidemia, smoking and thyroid disorders were excluded. cIMT, FMD and ABPI were calculated for all participants.

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“…Concerning disease characteristics, disease duration, anticentromere antibody positivity, cumulative glucocorticoid dose, and MRSS (negatively) have been reported to be associated with CVD and/or atherosclerosis in SSc (36,37,41,43). However, PAH was found to be associated with CVD only in a systematic review of the prevalence of coronary heart disease in SSc (1).…”

Section: Discussionmentioning

confidence: 99%

“…However, so far, only 1 study evaluated the consequences of previous glucocorticoid use on atherosclerosis in SSc patients (37). That study reported that higher cumulative glucocorticoid intake was associated with higher cIMT (OR 1.15).…”

Section: Discussionmentioning

confidence: 99%

Subclinical Atherosclerosis in Systemic Sclerosis: Not Less Frequent Than Rheumatoid Arthritis and Not Detected With Cardiovascular Risk Indices

Özen

İnanç

Ünal

et al. 2016

Arthritis Care & Research

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ObjectiveTo determine the frequency of subclinical atherosclerosis in patients with systemic sclerosis (SSc; scleroderma) compared to healthy subjects (HS) and rheumatoid arthritis (RA) patients and to determine the ability of cardiovascular (CV) risk indices in detecting SSc patients with subclinical atherosclerosis.MethodsA total of 110 SSc patients (102 females and 8 males, mean ± SD age 50.5 ± 11.9 years), 110 age‐ and sex‐matched RA patients, and 51 HS without CV disease were examined with ultrasonography (US). Carotid intima‐media thickness (cIMT) >0.90 mm and/or carotid plaques were used as the gold standard for subclinical atherosclerosis (US+). Systematic Coronary Risk Evaluation (SCORE), QRisk II, and 2013 American College of Cardiology (ACC)/American Heart Association (AHA) CV risk indices were calculated.ResultsTwenty‐one (19.1%) SSc patients, 24 (21.8%) RA patients, and 3 (5.9%) HS had subclinical atherosclerosis (SSc versus RA: P = 0.62, SSc versus HS: P = 0.029). cIMT in SSc was higher compared to HS (0.68 ± 0.15 mm versus 0.61 ± 0.10 mm; P = 0.008) but similar to RA patients (0.66 ± 0.14 mm; P = 0.82). Subclinical atherosclerosis in SSc was associated with age (odds ratio [OR] 1.07, P = 0.013), elevated erythrocyte sedimentation rate (OR 3.4, P = 0.045), and pulmonary arterial hypertension (OR 4.27, P = 0.012). Concerning CV risk indices, of the 21 US+ SSc patients only 0, 3 (14.2%), and 6 (28.6%) were classified as high CV risk according to SCORE, QRisk II, and ACC/AHA risk indices, respectively.ConclusionSubclinical atherosclerosis in SSc patients is more frequent than in HS, but is as frequent as in RA patients in which accelerated atherosclerosis is clearly defined. CV risk indices for the general population are considerably insufficient to detect SSc patients with atherosclerosis.

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Clinical and subclinical atherosclerosis in systemic sclerosis: consequences of previous corticosteroid treatment

Abstract: Our study confirms an increased prevalence of subclinical atherosclerosis in SSc patients and demonstrates a hitherto unknown association with corticosteroid cumulative dosage.

Cited by 31 publications

References 13 publications

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

Carotid Intima Media Thickness in Systemic Sclerosis Patients: Results From a Single Centre, Cross Sectional, Case-Control Study

Subclinical Atherosclerosis in Systemic Sclerosis: Not Less Frequent Than Rheumatoid Arthritis and Not Detected With Cardiovascular Risk Indices

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