Background Patients with antiphospholipid syndrome (APS) have been evaluated in the context of accelerated atherosclerosis in numerous studies, bringing this concept into the focus regarding proper treatment of this population of patients.
Objectives Carotid intima-media thickness (cIMT) has been established as a distinguished marker of cardiovascular risk. The aim of this study was to evaluate relationship between presence of more than one antiphospholipid antibody (aPL) and cIMT values in SLE patients with secondary APS.
Methods We analyzed 80 patients with systemic lupus erythematosus (SEL) and secondary APS 74 female (92.5%) and 6 male (7.5%), average age 49.4±13.1years. In all patients presence of lupus anticoagulans (LA), anticardiolipin (aCL IgG/IgM) and anti-β2 glycoprotein-I (anti-β2GPI IgG/IgM) antibodies has been established, and they were classified into group with only one or more than one aPL present in any combination. Measurement of cIMT has been performed on common carotid artery (CCA), its bifurcation (CCAbiff) and internal carotid artery (ICA) on both sides. We defined cIMT values 1.1mm and higher as plaque presence
Results There were 63.8% patients with more than one aPL present. Prevalence of standard atherosclerotic risk factors was below 40%. Age, hypertension, presence of diabetes mellitus and hyperlipidemia resulted in higher values of cIMT in studied group patients. Average values of cIMT were significantly higher in patients with more than one aPL present for almost all segments of carotid trunk (CCA right, p=0.009, CCA left, p=0.034, CCAbiff right, p=0.093, CCAbiff left, p=0.632, ICA right, p=0.027, ICA left, p=0.544). After adjustment for age, current cigarette smoking, diabetes, hypertension and hyperlipidemia, the relative odds for atherosclerotic plaque presence on carotid arteries in SLE patients with APS and more than one aPL present was 4.19 (95% confidence interval 0.09 to 0.95, p=0.041).
Conclusions Presence of more than one aPL in SLE patients with APS additionally accelerate atherosclerotic continuum. In this subgroup of APS patients more aggressive approach towards prevention and control of standard atherosclerotic risk factors is crucial.
Acknowledgements This work was supported by research grant number 175041 for 2011-2015, issued by the Ministry of Science of the Republic of Serbia.
Disclosure of Interest None declared