Premature atherosclerosis in primary antiphospholipid syndrome: preliminary data

Abstract

Objective: To investigate the atherosclerosis hypothesis in primary antiphospholipid syndrome (PAPS). Methods: The intima media thickness (IMT) of carotid arteries and other cardiovascular risk factors was measured in 20 patients with PAPS (mean (SD) age 35 (12) years) and in 20 controls matched for age and sex (34 (12) years). Results: The frequency of smoking, hypertension, and dyslipidaemia was similar in the two groups, but plasma homocysteine was higher in patients with PAPS (mean (SD) 11.9 (6.2) v 8.2 (3.4) mmol/l, p = 0.037). The IMT was slightly greater in patients with PAPS than in controls at the carotid bifurcation (mean (

Accelerated Atherosclerosis in Autoimmune Rheumatic Diseases

“…60 Another recent study also provides additional evidence for enhanced atherosclerosis in APS, because carotid IMT, both at the carotid bifurcation and at the internal carotid artery, was higher among 20 primary APS patients compared with 20 control subjects, primarily in patients Ͼ40 years old. 61 The issue of primary versus secondary APS in terms of atherosclerosis extent has recently been addressed by Jimenez et al 62 They have consecutively studied 70 SLE patients, 25 primary APS patients, and 40 healthy women for carotid artery atherosclerosis. Whereas the IMT levels were similar among the 3 study groups, the prevalence of carotid plaques was higher and appeared earlier in SLE patients than in the primary APS or the control groups.…”

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“…Antiphospholipid antibodies can also crossreact with high-density lipoprotein complex (HDL-C) and apolipoprotein A-I (Apo A-I) (a major constituent of the HDL-C), possibly reducing the antiatherogenic effects of HDL (43). In primary APS patients, particularly those older than 40 years, the carotid intima-media thickness (cIMT) is increased compared with that in controls (44). However, an independent association between aPL and carotid atherosclerosis, coronary artery calcification (CAC), and CVD in SLE patients has not been confirmed by all the studies (33,36,(44)(45)(46)(47)(48)(49) (52).The major concern was the three-to fivefold increased risk of pre-eclampsia, complicating 16%-30% of SLE pregnancies (53).…”

Cardiovascular Events in Systemic Lupus Erythematosus: Mechanisms for the Accelerated Development of Atherosclerosis, Diagnosis, Correction Capabilities

“…Антифосфолипидные антитела (АФА) часто обнаружива-ются у пациентов с СКВ и рассматривались как возмож-ные предикторы атеросклероза, хотя исследования, про-веденные для оценки их роли, показали неоднозначные результаты [24][25][26][27]. В то же время отмечается существен-ное увеличение субклинического маркера атеросклеро-за -толщины комплекса интима-медиа (КИМ) у паци-ентов с первичным антифосфолипидным синдромом (АФС) по сравнению с контрольной группой [25].…”