Background Behçet’s disease (BD) is a distinctive systemic vasculitis, able to involve both veins and arteries. Subclinical atherosclerosis apart from traditional cardiovascular (CV) risks is independently known to be associated with systemic vasculitis . Endothelial dysfunction is a characteristic feature of BD. Peripheral arterial disease (PAD) in BD is very uncommon. Although BD does not appear to increase the risk of CV and PAD, the preliminary data is controversial. The Ankle-Brachial Pressure Index (ABPI) is a non-invasive vascular function test for the assessment of CV and PAD risk . The ABPI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressures in the arm. The normal ABPI is 0,9-1,2. Value lesser than 0,9 indicates reduced lower extremity blood flow and peripheral arterial disease. Value higher than 1,3 suggests calcification of the arterial vessels or reflects severe peripheral vascular disease.
Objectives In this study, we aimed to assess the CV risk by measuring ABPI in patients with BD and healthy controls and to analyse its associations with clinical and serological parameters.
Methods A total of 35 patients with BD (mean age: 31±11 years) and 20 age- and sex-matched healthy controls (mean age; 30±6 years) and 18 controls with rheumatoid arthritis (mean age; 36±10 years) were included. Patients with known hypertension, coronary artery disease, diabetes, hyperlipidemia were excluded. ABPI was measured with a hand-held Doppler ultrasound. Patient charateristics, treatments, activity status and smoking were recorded.
Results ABPI was in normal range in all patients. There were no significant difference between the BD, healthy and rheumatoid control groups (mean ABPI (min-max) was 1,08 (0,92-1,2); 1,11 (1,0-1,23), 1,09 (0,91-1,2) respectively, > 0,05). 8 of 35 patients with BD had vascular involvement. 13 patients were using steroid for at least 3 months. 53% of patients were receiving immunosuppressants such as azathioprine, cyclosporine, interferon or anti-TNF agents. 71% of patients were in inactive period. The median duration of disease was 6 years with a range of 1 to 20 years in BD group. ABPI did not significantly differ between the patients with shorter or longer than 5 years disease duration or depending on steroid usage. ABPI did not significantly differ between the active and inactive patients in BD (median 1,07 (1-1,2) vs 1,08 (0,92-1,2), p > 0,05). 8 and 4 participants were smoking in the disease and control group, respectively.
Conclusions Based on these measurements, ABPI was not found to be lower or higher in BD when compared to healthy controls and patients with RA.
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Yeboah, J., et al., Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA, 2012. 308(8): p. 788-95.
Disclosure of Interest None Declared
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