Intima-media thickness in secondary anti-phospholipid syndrome patients: Impact of disease activity

Aim of the workTo assess the carotid intima-media thickness (IMT) and plaque formation in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS) by doppler ultrasonography and to correlate it with the clinical features, disease activity and damage.Patients and methodsThirty-six female SLE patients with secondary APS and another 36 without were included. Thirty-six matching healthy volunteers were included as control. In patients, the disease activity and damage were assessed using the SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics (SLICC) index, respectively. Doppler ultrasound was carried out for patients and control and the IMT was measured.ResultsThe demographic and clinical characteristics of patients are presented. The disease activity was significantly higher in SLE patients with APS (19.7 ± 7.9) compared to SLE only patients (15.1 ± 9.2) (p = 0.03). The low density lipoprotein (LDL) was significantly increased in APS patients (p = 0.04). The IMT was comparable between both groups (0.83 ± 0.15 mm) vs (0.86 ± 0.2 mm) (p = 0.55) and both were significantly increased compared to the control (0.61 ± 0.11 mm) (p < 0.0001). The dyslipidemia present in the patients showed a significant difference in the measured lipid profile parameters (p < 0.0001). The IMT significantly correlated with the SLEDAI in both groups (p < 0.002 and <0.001 respectively).ConclusionThe increased IMT as a marker of atherosclerosis is confirmed in SLE patients with no obvious difference in those with secondary APS. The link between the increased IMT and disease activity favors the role of disease-specific potential risk factors, in addition to the traditional conventional ones, in the development of atherosclerosis.