Study of macrovascular disease in systemic sclerosis

Abstract EN

Subjects: Included 20 systemic sclerosis (SSc) patients (Group I) fulfilling the American College of Rheumatology (ACR) criteria.

They were 17 F (85%): 3M (15%).

Their age ranged from 29-50 years (mean 40.2?5.6).

The disease duration ranged from one to 13 years (mean 5.45?3.6).

They comprised 12 of the localized type and 8 of the diffuse type.

The patients were chosen without regard to their macrovascular disease.

Ten healthy subjects (Group II) age and sex matched with the patients were included as a control group.

They were also unselected for vascular or any other complications.

Methods: Both groups were screened for convential atherosclerotic risk factors, which included random blood cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides and fasting glucose level.

Assessment included measurement of blood pressure, smoking history and determination of systemic sclerosis status.

Macrovascular disease was assessed using non-invasive vascular examination with Duplex Doppler scanning and measurement of Ankle Brachial Pressure Index (ABPI) to identify the presence of asymptomatic peripheral vascular disease.

Results: There was an increase in the evidence of macrovascular disease in systemic sclerosis patients than the control subjects, where carotid artery disease was detected in 11 patients with varying degrees of severity as compared with one control subject.

Also plaque formation was detected in 13 patients as compared to 2 controls.

Evidence of peripheral vascular disease was present by lowering of ABPI in systemic sclerosis patients more than the controls.

No significant difference was found between both groups as regards the risk factors measured in the study.

Conclusion: Regular non-invasive vascular assessment with carotid Duplex scanning and detection of asymptomatic peripheral vascular disease may identify SSc patients with macrovascular disease at an early stage for proper management and prevention of complications.