title: A pilot study of subclinical coronary atherosclerosis in systemic sclerosis: coronary artery calcification in cases and controls.
abstract: OBJECTIVE
  Systemic sclerosis (SSc) is associated with vasculopathy and endothelial cell injury, which could potentially increase the risk of coronary atherosclerosis. Multidetector computed tomography, a noninvasive procedure, generates a coronary calcium score (CCS) as a marker for coronary atherosclerosis. Serum proinflammatory high-density lipoprotein (piHDL) is a potential novel marker of atherosclerotic risk. The objective of the pilot study was to determine 1) the prevalence of subclinical coronary atherosclerosis in SSc and 2) serum piHDL levels as a potential novel marker of atherosclerotic risk in SSc.
  
  
  METHODS
  A cross-sectional study of 17 patients with SSc and 17 age-, sex-, and race-matched healthy controls in Cincinnati, Ohio, was conducted. Measurements included CCS; body mass index; lipid profile; and serum levels of high-sensitivity C-reactive protein, homocysteine, and piHDL.
  
  
  RESULTS
  Patients with SSc were slightly older (mean 52.8 years) than control subjects (mean 50.6 years; P = 0.01). Coronary calcium was found in 12 participants (9 with SSc, 3 controls; P = 0.03). The mean +/- SD CCS in patients with SSc was significantly greater than the controls (126.6 +/- 251.0 versus 14.7 +/- 52.2; P = 0.003). Five patients with SSc (29%), but no controls, had detectable levels of piHDL (P = 0.06).
  
  
  CONCLUSIONS
  Prevalence of subclinical coronary atherosclerosis is greater in patients with SSc compared with healthy controls. These findings should be confirmed in a larger study.
authors.affiliation: University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: Vandana
authors.initials: V
authors.lastname: Khurma
authors.forename: Cris
authors.initials: C
authors.lastname: Meyer
authors.forename: Grace S
authors.initials: GS
authors.lastname: Park
authors.forename: Maureen
authors.initials: M
authors.lastname: McMahon
authors.forename: Jan
authors.initials: J
authors.lastname: Lin
authors.forename: Ram Raj
authors.initials: RR
authors.lastname: Singh
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
mesh_terms: D002114:Calcinosis / Q000209:etiology*; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D012595:Scleroderma, Systemic / Q000150:complications*