AB1453 TRADITIONAL AND NON-TRADITIONAL CARDIOVASCULAR RISK FACTORS IN THE DEVELOPMENT OF EARLY ATHEROSCLEROSIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND RHEUMATOID ARTHRITIS

Abstract

BackgroundIt is known that patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are characterized with a variability of traditional and non-traditional cardiovascular risk factors for the early development of arthrosclerosis. The results of numerous studies, examining the significance of these factors for the development of atherosclerosis in patients with autoimmune rheumatic disease (ARD), are contradictory. Additionally the prevalence of these factors was compared between ARD patients and healthy persons. There are few data about comparison cardiovascular risk factors between patient with SLE, RA and ischemic heart disease (IHD).ObjectivesThe aim of our study was to determine the frequency of occurrence of traditional and non-traditional cardiovascular risk factors in patients with SLE and RA in comparison to patients with IHD and to assess their role for the development of early atherosclerosis.MethodsThe study included 85 female patients with ARD (SLE (n=40), mean age 33,5 (27,5; 44,5) years old, disease duration 8,0 (5,0; 14,5) years, disease activity SLEDAI-2K 7,0 (4,0; 11,5) points and RA (n=45), mean age 43,0 (33,0; 52,0) years old, disease duration 9,0 (5,0; 13,0) years, disease activity (DAS28=5,37 (4,69;5,89) points. Fifty four healthy women of the same age formed the first control group (CG1), 22 women with IHD (mean age 50,0 (48,0; 51,0) years old) made the second control group (CG2).The presence of traditional (age, arterial hypertension (AH), smoking, obesity, dyslipidemia, low physical activity, family history of cardiovascular disease (CVD)) and non-traditional (menopause, hyperhomocysteinemia (HHC)) risk factors was assessed. The early development of atherosclerosis was confirmed with the help of common carotid artery sonography according to standard procedures.ResultsIt was found that only AH and HHC were more in patients with SLE and RA in comparison to CG1 (AH: 65% vs. 0% (р<0,0001), HHC: 45% vs. 9% (р<0,0001), respectively for SLE patients and 27% vs. 0% (р<0,0001), 36% vs. 9% (р=0,001), respectively for RA patients). Age, smoking, obesity, dyslipidemia, low physical activity, family history of CVD, menopause were similar in both groups of patients and CG1. It was revealed that patients with SLE were 14 years younger (р<0,0001) than female patients with IHD. They had less often family history of CVD (18% vs. 41%, р=0,044), but HHC was revealed 2 times more often (45% vs. 22%, р=0,031) than in CG2. Patients with RA were 8 years younger than patients with IHD (р=0,007). Moreover the frequency of occurrence of AH, obesity, dyslipidemia, family history of CVD was less than in CG2 (27% vs. 73% (р=0,0003), 40% vs. 68% (р=0,030), 71% vs. 95% (р=0,025), 11% vs. 41% (р=0,005), respectively). HHC was detected 1,5 times more often in RA patients in comparison to patients with IHD, but without statistically difference (36% vs. 22%, p=0,288). Other risk factors were similar in both groups of patients with ARD and IHD.The presence of subclinical atherosclerosis was observed in 54% patients with ARD. Comparative analysis of the frequency of occurrence of investigated cardiovascular risk factors between these patients and those with IHD has shown the highest prevalence of HHC in patients with ARD (54% vs. 22%, p=0,014), what could be as a result of autoimmune inflammation in this group of patients.ConclusionThus, we revealed a high prevalence of AH (as traditional risk factor) and HHC (as non-traditional risk factor) in patients with SLE and RA. More than half of patients with ARD had subclinical atherosclerosis. The presence of HHC in patients with SLE and RA may be associated with the development of early atherosclerosis.