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Clinical aspects

 

Endothelial dysfunction and subclinical atheromatosis in patients with systemic sclerosis

1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Rheumatology Department, University Hospital HM Sanchinarro, Madrid, Spain. reumatologia.hms@hmhospitales.com
  2. Rheumatology Department, University Hospital HM Sanchinarro, Madrid, Spain.
  3. Rheumatology Department, University Hospital HM Sanchinarro, Madrid, Spain.
  4. National Cardiovascular Research Centre (CNIC), Madrid, Spain.
  5. Angiology & Vascular Surgery Department, University Hospital HM Sanchinarro, Madrid, Spain.
  6. Angiology & Vascular Surgery Department, University Hospital HM Sanchinarro, Madrid, Spain.
  7. Rheumatology Department, University Hospital HM Sanchinarro, Madrid, Spain.
  8. Rheumatology Department, University Hospital HM Sanchinarro, Madrid, Spain.
  9. Angiology & Vascular Surgery Department, University Hospital HM Sanchinarro, Madrid, Spain.
  10. Rheumatology Department, University Hospital HM Sanchinarro, Madrid, Spain.

CER12664
2020 Vol.38, N°3 ,Suppl.125
PI 0048, PF 0052
Clinical aspects

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PMID: 32083542 [PubMed]

Received: 07/08/2019
Accepted : 16/12/2019
In Press: 20/02/2020
Published: 26/08/2020

Abstract

OBJECTIVES:
To assess subclinical vascular features in patients with systemic sclerosis (SSc) via carotid ultrasound, and flow-mediated vasodilation (FMD), as measures of cardiovascular risk (CVR).
METHODS:
This was a cross-sectional study of 70 patients diagnosed with SSc (diffuse or limited forms), on whom a vascular study protocol was performed to assess angiodynamic parameters measured by FMD in brachial artery and carotid ultrasound lesions: carotid intima-media thickness (CIMT) and carotid atheroma plaques (AP). Classical CVR factors were also assessed, as well as main features of SSc regarding skin and organic involvement, laboratory parameters, presence of autoantibodies and specific treatments.
RESULTS:
94% of patients were women with a mean age of 50.2±12.5 years. 84% had endothelial dysfunction (ED), being severe in 49%, statistically associated with glucocorticoid (GC) treatment (OR=8.78; CI=1.52-50.78; p=0.015). CIMT was pathological in 39%, 23% had AP (none had significative haemo-dymanic stenosis). Serum vitamin D concentration (25(OH)D3) showed a protective effect on CIMT (OR=0.94; CI=0.89-0.99; p=0.025). No differences between types of SSc were obtained; neither association between SSc features and classical CVR factors.
CONCLUSIONS:
GC treatment has implications in CVR, despite in SSc GC doses administered are lower than in other autoimmune diseases (in our cohort even prednisone ≤10 mg daily was associated with ED). GC may be associated with an early vascular damage in these patients, which could lead to changes in FMD, ED and finally AP. On the other hand, optimum levels of 25(OH)D3 seemed to be beneficial against vascular damage.

Rheumatology Article