Macrovascular affection in systemic sclerosis

Abstract EN

Objective : the aim of this study was to elucidate early macro vascular affection in systemic sclerosis (SSc) patients and to find out its relation to ant centromere antibody (ACA) in order to attenuate such complication if present.

Methodology : this study was carried out on thirty SSc female patients fulfilling the 1980 American Rheumatology Association (ARA) Criteria for systemic sclerosis.

They were classified into twenty limited cutaneous SSc (LcSSc) and ten diffuse cutaneous SSc (DcSSc) patients according to clinical examinations.

Fifteen, age and sex matched healthy controls were also included.

Serum ACA was assessed by ELISA technique.

Ankle brachial pressure index (ABPI) and Carotid Duplex Scan (CDS) were used to detect the presence of large vessel affection.

Patients with high risk factors for peripheral arterial occlusive disease (PAOD) were excluded from the study.

Patients receiving steroids and oral contraceptive pills were also excluded from the study.

Results: The results of our study showed no statistically significant difference in the levels of basic risk factors for PAOD (serum cholesterol, triglycerides and glucose, high and low density lipoproteins) between LcSSc, DcSSc and the control group (p > 0.05).

There was a high statistically significant reduction in ABPI in LcSSc patients compared to controls, while no statistically significant difference was found between DcSSc patients and controls, whereas a statistically significant reduction in ABPI was found in LcSSc compared to DcSSc patients as p < 0.001, p > 0.05 and p < 0.05 respectively.

There was a statistically significant increase in carotid artery intimal thickening (CAIT) in DcSSc patients compared to controls as well as between DcSSc patients compared to LcSSc patients while no significant difference was found between LcSSc patients and controls as p < 0.05, p < 0.05 and p > 0.05 respectively.

There was a statistically significant reduction in ABPI in SSc patients with positive ACA compared to those with negative ACA as p < 0.05.

Conclusion : Macro vascular affection is considered a complication in SSc patients who have higher incidence of lower limb large vessel abnormalities in LcSSc patients as evidenced by ABPI and central large vessel affection in DcSSc patients as evidenced by CDS.

Also, we can conclude that there is an association between ACA and peripheral macro vascular affection in LcSSc patients.