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

Abstract

Aim of the workTo measure the extent of subclinical atherosclerosis in patients with systemic sclerosis, and to evaluate any potential vascular risk factors in these patients. Patients and methodsThis 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. ResultsThe mean IMT of CCA was higher in systemic sclerosis patients (right 0.67±0.11mm, left 0.67±0.12mm) when compared with the control group (right 0.48±0.2mm, left 0.54±0.13mm) (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. ConclusionThere 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.