Increased carotid artery intima-media thickness as an indicator of the onset of atherosclerosis in patients with connective tissue systemic diseases.
BACKGROUND
Systemic connective tissue diseases have an autoimmunological background. Atherosclerosis is the main cause of ischaemic heart disease in patients with these disorders, particularly in young females. Atherosclerotic process begins in the intimal and medial layers of arterial wall. Early detection of these changes may have important clinical implications.


OBJECTIVE
To assess the intima-media thickness (IMT) in carotid arteries in patients with connective tissue disorders and to correlate IMT with the presence of antiphospholipid (aPL) antibodies.


METHODS
The study group consisted of 74 patients (63 females, 11 males) with documented connective tissue disease and 75 (62 females, 13 males) control subjects without clinical symptoms suggesting atherosclerosis. The IMT values, measured using ultrasonography, and aPL (IgG and IgM) antibody titre were assessed in all subjects.


RESULTS
Mean aPL IgG and IgM values were significantly higher in patients than in controls (9.22 GMP/ml vs 6.59 GMP/ml, p<0.01; and 18.59 MPL/ml vs 12.05 MPL/ml, p<0.01, respectively). Patients with connective tissue diseases had significantly higher IMT values than controls (0.82 mm vs 0.57 mm, p<0.01). The IMT values positively correlated with age, presence of aPL antibodies, hypercholesterolemia and duration of the disease.


CONCLUSIONS
The presence of aPL antibodies and increased IMT may indicate atherosclerosis in young patients with connective tissue diseases, and identify those who need more intensive prophylactic treatment in order to decrease the risk of atherosclerosis-related complications and death.
Dropiński
Jerzy
J
II Department of Internal Diseases, Jagiellonian University, Cracow, Poland.
Szczeklik
Wojciech
W
Wegrzyn
Wojciech
W
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D003240:Connective Tissue Diseases / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
D017152:Antibodies, Antiphospholipid; D007074:Immunoglobulin G; D007075:Immunoglobulin M