TY - JOUR
TI - Atherosclerosis in premenopausal women with antiphospholipid syndrome
and systemic lupus erythematosus: a controlled study
AU - Vlachoyiannopoulos, PG
AU - Kanellopoulos, PG
AU - Ioannidis, JPA and
AU - Tektonidou, MG
AU - Mastorakou, I
AU - Moutsopoulos, HM
JO - The Lancet Rheumatology
PY - 2003
VL - 42
TODO - 5
SP - 645-651
PB - Oxford University Press
SN - null
TODO - 10.1093/rheumatology/keg182
TODO - antiphospholipid syndrome; systemic lupus erythematosus;
atherosclerosis; vascular ultrasound; intima-media thickness; carotid
artery; femoral artery
TODO - 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-beta(2)GPI 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.
ER -