Background Patients with antiphospholipid syndrome (APS) have an increased risk of atherosclerosis.
Objectives The aim of our study was to determine whether there are subclinical arterial changes in APS patients, and what is the best diagnostic choice for their establishment.
Methods In this study we analyzed 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients with Systemic Lupus Erythematosus and APS (SAPS). The results were compared to 30 controls. The groups were comparable with respect to age, gender, and traditional risk factors except for the lipid status, since controls had significantly higher levels of cholesterol and triglycerides. Study was conducted on 64-multi-sliced computed tomography (64-MSCT) and only the new changes that have not been verified until this exam were taken into analysis.
Results There was significantly higher incidence of overall arterial changes in PAPS and SAPS patients, as compared to healthy controls. We detected a total of 70 arterials stenosis in PAPS patients, and 79 arterial stenosis in SAPS patients, compared to 43 in the control group (χ2=16.95, p <0,001, χ2=30.14, p <0,001, respectively). There were 20 newly discovered visceral blood vessel lesions in the patients with APS and 5 lesions in the control group. There was significantly higher incidence of overall visceral arterial changes comparing to controls since in PAPS patients the sum of 10 and in SAPS the sum of 5 arterials stenosis compared to 5 in control group was detected (p< 0.001). Significant changes in PAPS and SAPS patients comparing to controls were detected on celiac artery (10pts vs.3pts vs. 3pts; p< 0.05), superior mesenteric artery (6pts vs. 2pts. vs. 0pts; p< 0.05) and right renal artery (4pts vs. 0 pts. vs. 2pts; p< 0.05).
Conclusions APS patients suffer from accelerated atherosclerosis, and the 64-MSCT angiography is the method of choice in monitoring disease progression, because it is a safe, has the lowest degree of error, and provides an overview of the arteries that are otherwise difficult to access. This enables timely treatment of these patients with drugs or interventional radiology procedures
Jimenez S, Garcia-Criado A, Tassies D, Reverter JC et all. Preclinical vascular disease in systemic lupus erythematosus and primary antiphospholipid syndrome. Rheumatology 2005; 44: 756–761.
Ames PR, Margarita A, Sokoll KB, Weston M et al. Premature atherosclerosis in primary antiphospholipid syndrome: preliminary data. Ann Rheum Dis 2005; 64: 15–317.
Saponjski J, Stojanovich L, Djokovic A, Petkovic M, Mrda D. Systemic vascular diseases in the antiphospholipid syndrome. What is the best diagnostic choice? Autoimmun Rev. 2010 Nov 21. [Epub ahead of print]PMID: 21095242 [PubMed - as supplied by publisher].
Acknowledgements We thank all patients who participated in this study and our colleagues from many clinics in Serbia. This work was supported by research grant number 175041 for 2011 - 2014, issued by the Ministry of Science of the Republic of Serbia.
Disclosure of Interest None Declared
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