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

Abstract

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.

Arterial evaluation of systemic sclerosis patients with Doppler ultrasound: What did we find?

“…On the other hand, no significant associations were found between the presence of macrovascular involvement and the sedimentation and blood glucose values. The authors reported they found no relationship between disease subtypes 24 . The fundamental differences between the results of our study and these studies can be listed as follows: the limited number of patients in our control group, the majority of our cohort comprising of the limited subtype of SSc, and the rather low levels of disease severity scores in our patients.…”

Periodontal Diseases and Lipid Profile in Systemic Sclerosis: an EUSTAR Cohort Experience

“…Although we have previously reported an impaired lipid profile in different SSc settings [14][15][16][17][18][19], available data on total cholesterol and its fractions, low-density and highdensity lipoprotein cholesterol, triglycerides and lipoproteins (A, B) in SSc subsets is controversial [20][21][22][23][24][25]. Thus, decreased HDL-cholesterol was detected in patients with limited cutaneous disease, while abnormal values in other studies performed in SSc [20][21][22][23][24][25].…”