Rheumatology 2003; 42: 645-651
© 2003 British Society for Rheumatology
Atherosclerosis in premenopausal women with antiphospholipid syndrome and systemic lupus erythematosus: a controlled study
Department of Pathophysiology Medical School, National University of Athens,
1 Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, Ioannina and
2 Department of Radiology, Onassis Cardiac Surgery Center, Athens, Greece
Objective. To evaluate whether premenopausal women with antiphospholipid syndrome (APS) or systemic lupus erythematosus (SLE) have increased prevalence of atherosclerosis after adjustment has been made for known cardiovascular risk factors.
Methods. We evaluated premenopausal women with APS in comparison with age-matched groups of patients with SLE [positive or negative for anticardiolipin (aCL) antibodies] or rheumatoid arthritis (RA), and healthy subjects. Thirty-three subjects in each group were assessed for cardiovascular risk factors, including a detailed lipid profile. Ultrasonography of carotid and femoral arteries assessed the intima-media thickness (IMT) and the presence of atherosclerotic plaque.
Results. Atherosclerotic plaques were detected in 5, 2, 4, 1 and 1 subject in the five groups respectively. APS patients had significantly more affected vessels than RA patients and healthy controls (P=0.042 and P=0.016, respectively), but not compared with SLE patients. No consistent differences in IMT, traditional cardiovascular risk factors or lipid parameters were detected among the five groups. The odds for atherosclerosis independently increased 1.19-fold per year of increasing age [95% confidence interval (CI) 1.08–1.31; P=0.001), 1.019-fold per 1 mg/dl increase in low-density lipoprotein (LDL) (95% CI 1.003–1.036; P=0.020), 1.035-fold per additional 1 g of methylprednisolone equivalent cumulative corticosteroid dose (95% CI, 0.996–1.074; P=0.074), and 4.35-fold in the presence of APS or SLE (95% CI 0.75–25.2; P=0.10). Neither aCL nor anti-ß2GPI antibodies were associated with atherosclerosis.
Conclusion. Premenopausal APS and SLE women have an increased prevalence of carotid and femoral plaque that is not accounted for by other predictors of atherosclerosis, including age, lipid parameters and cumulative steroid dose.
KEY WORDS: Antiphospholipid syndrome, Systemic lupus erythematosus, Atherosclerosis, Vascular ultrasound, Intima-media thickness, Carotid artery, Femoral artery.
Correspondence to: P. G. Vlachoyiannopoulos, Department of Pathophysiology, Medical School, National University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece. E-mail: pvlah{at}med.uoa.gr
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. E. Hettema, H. Bootsma, and C. G. M. Kallenberg Macrovascular disease and atherosclerosis in SSc Rheumatology, May 1, 2008; 47(5): 578 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Telles, C. Lanna, G. Ferreira, A. Souza, T. Navarro, and A. Ribeiro Carotid atherosclerotic alterations in systemic lupus erythematosus patients treated at a Brazilian university setting Lupus, February 1, 2008; 17(2): 105 - 113. [Abstract] [PDF]
|
|
|
|
|
|
K. de Leeuw, R. Graaff, R. de Vries, R. P. Dullaart, A. J. Smit, C. G. Kallenberg, and M. Bijl Accumulation of advanced glycation endproducts in patients with systemic lupus erythematosus Rheumatology, October 1, 2007; 46(10): 1551 - 1556. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Der, G. Kerekes, K. Veres, P. Szodoray, J. Toth, G. Lakos, G. Szegedi, and P. Soltesz Impaired endothelial function and increased carotid intima-media thickness in association with elevated von Willebrand antigen level in primary antiphospholipid syndrome Lupus, July 1, 2007; 16(7): 497 - 503. [Abstract] [PDF]
|
|
|
|
|
|
C. Christodoulou, S. Sangle, and D. P. D'Cruz Vasculopathy and arterial stenotic lesions in the antiphospholipid syndrome Rheumatology, June 1, 2007; 46(6): 907 - 910. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L R Lopez, M Salazar-Paramo, C Palafox-Sanchez, B L Hurley, E Matsuura, and I Garcia-De La Torre Oxidized low-density lipoprotein and {beta}2-glycoprotein I in patients with systemic lupus erythematosus and increased carotid intima-media thickness: implications in autoimmune-mediated atherosclerosis Lupus, February 1, 2006; 15(2): 80 - 86. [Abstract] [PDF]
|
|
|
|
 |
|
 Y. Shoenfeld, R. Gerli, A. Doria, E. Matsuura, M. M. Cerinic, N. Ronda, L. J. Jara, M. Abu-Shakra, P. L. Meroni, and Y. Sherer Accelerated Atherosclerosis in Autoimmune Rheumatic Diseases Circulation, November 22, 2005; 112(21): 3337 - 3347. [Full Text] [PDF]
|
|
|
|
|
|
C. Gorman and D. Isenberg Atherosclerosis and lupus Rheumatology, August 1, 2004; 43(8): 943 - 945. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Ohlenschlaeger, P. Garred, H. O. Madsen, and S. Jacobsen Mannose-Binding Lectin Variant Alleles and the Risk of Arterial Thrombosis in Systemic Lupus Erythematosus N. Engl. J. Med., July 15, 2004; 351(3): 260 - 267. [Abstract] [Full Text] [PDF]
|
|