Predictors of cardiovascular risk in systemic autoimmune diseases

Background: Aim of our study was to investigate whether rheumatic autoimmune diseases are associated with an increased Carotid Intima-Media Thickness (C-IMT) and to evaluate possible discrepancies existing among the single pathological identities. Methods: This study involved a total of 216 subjects, 108 patients with systemic rheumatic diseases and 108 healthy controls. Our patients (15 males, age 51±14 yrs), all fulfilling the ACR criteria for rheumatic autoimmune diseases were subdivided into two groups: 1) Group SSc (Sclerodermic pts): 62 patients (7 males, age 52±14 yrs); 2) Group NoSSc (Non-Sclerodermic pts): 46 patients (8 males, age 51±14 yrs). All patients underwent to structured interview, physical examination, laboratory evaluation and echo-color Doppler of the carotid arteries. Results: We found that total cholesterol (TC) was higher in patients than controls (207±36 vs. 174±31 mg/dL, p<0.05), as well as LDL-C (131±30 vs. 104±29 mg/dL, p<0.05) and triglycerides (148±65 vs. 99±40 mg/dL, p<0.05). HDL-C was significantly lower, indeed, in patients than controls (47±10 vs. 50±10 mg/dL, p<0.05). Blood fasting glucose was similar in both patients and controls (105±18 mg/dL vs. 105±16 mg/dL, p=ns). Mean Body mass index was identical in the two groups, (mean value: 25±4 kg/m2). Comparing SSc group and NoSSc group, we observed that TC (209±36 vs. 204±37 mg/dL), LDL-C (137±31 vs. 124±27mg/dL) and triglycerides (139±61Vs 160±70 mg/dL) were significantly higher in SSc, whereas HDL-C, blood fasting glucose and BMI were not significantly different. In autoimmune pts C-IMT was 0.86 mm (range 0.73 to 0.99 mm), statistically different from C-IMT in control subjects, that was 0.65±0.17 mm (p<0.05), and resulted from the following values: 0.92±0.1 mm in SSc group and 0.78±0.13 in NoSSc group. The difference between group was significant (p<0.05). Conclusions: Patients with rheumatic autoimmune diseases had clear signs of subclinical atherosclerosis (assessed by means of C-IMT) than healthy controls, thus have an overall increased cardiovascular risk profile. Further researches are needed in order to improve life duration and cardiovascular outcomes of these patients.