title: [Significance of antiphospholipid syndrome and antiphospholipid antibodies in patients with systemic lupus erythematosus in estimation of risk of subclinical atherosclerosis development].
abstract: BACKGROUND
  Atherosclerosis is an important clinical problem in patients with systemic lupus erythematosus (SLE), because of very severe cardiovascular and central nervous system manifestations.
  
  
  OBJECTIVE
  Estimation if antiphospholipid syndrome (APS) and antiphospholipid antibodies (aPL) are risk factors for subclinical atherosclerosis in patients with SLE.
  
  
  METHODS
  We examined 103 patients with SLE and 30 healthy volunteers, included as the control group. Coexistence of APS was confirmed in 35 patients. Evaluation of subclinical atherosclerosis was done on the basis of measurement of intima-media thickness (IMT) in B-mode ultrasound examination. We considered classical atherosclerotic risk factors and determined profile of aPL: anti-cardiolipine antibodies (aCL), anti beta2 glycoprotein-I antibodies, antiprothrombin antibodies (aPT), anti-oxidized low-density lipoprotein antibodies and lupus anticoagulant (LA). Statistical analysis was performed with chi2 Yates, chi2 Pearson and R rang Spearman tests. Multivariate regression analysis was also done.
  
  
  RESULTS
  Thickened IMT was significantly more frequent in patients with SLE than in controls (p = 0.0002). We found that coexistence of APS is a risk factor for moderate thickening of IMT (OR: 3.41; 95% CI: 1.0-11.5). We also confirmed that the presence of aPL is significantly correlated with IMT ranging from 0.66 to 0.86 mm. The highest risk was found in patients with the presence of aPT IgA (OR: 5.50; 95% CI: 1.1-30.2), aCL IgM (OR: 4.36; 95% CI: 1.1-20.7), LA (OR: 4.02; 95% CI: 1.1-19.4) and aCL IgG (OR: 2.99; 95% CI: 1.1-9.7). Moreover, we found that ischaemic heart disease, nephropathy and myocardial infarction were significantly more frequent in patients with thickened IMT.
  
  
  CONCLUSIONS
  Patients with SLE develop subclinical atherosclerosis significantly more frequent than the general population. Coexistence of APS and presence of aPL are risk factors for subclinical atherosclerosis development in patients with SLE. Thickened intima-media in patients with SLE is significantly associated with an increased risk of cardiovascular manifestations.
authors.affiliation: Klinika Reumatologii, Pomorska Akademia Medyczna, Szczecin. labreum@sci.pam.szczecin.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Fischer
authors.forename: Marek
authors.initials: M
authors.lastname: Brzosko
authors.forename: Anna
authors.initials: A
authors.lastname: Walecka
authors.forename: Lidia
authors.initials: L
authors.lastname: Ostanek
authors.forename: Marcin
authors.initials: M
authors.lastname: Sawicki
mesh_terms: D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000453:epidemiology* / Q000276:immunology*; D001161:Arteriosclerosis / Q000453:epidemiology* / Q000276:immunology; D015415:Biomarkers; D016022:Case-Control Studies; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D017539:Tunica Intima / Q000276:immunology*
chemical_list: D017152:Antibodies, Antiphospholipid; D015415:Biomarkers