title: Primary antiphospholipid syndrome: absence of premature atherosclerosis in patients without traditional coronary artery disease risk factors.
abstract: OBJECTIVE
  To investigate if patients with Primary Antiphospholipid Syndrome (PAPS) with venous and/or arterial thrombosis without traditional coronary artery disease (CAD) risk factors develop early atherosclerotic vascular damage.
  
  
  METHODS
  27 female patients with PAPS (Sidney criteria) and 27 age, body mass index (BMI), and sex matched controls were consecutively selected. Exclusion criteria were: black race, age ≥55 years, traditional cardiovascular risk factors, other thrombophilias or connective tissue diseases, corticosteroids use and pregnancy. All subjects underwent Pulse Wave Velocity (PWV) and Echo-Tracking (ET), both in carotidal bed, to analyse vascular functional properties.
  
  
  RESULTS
  Age (p = 0.92) and BMI (p = 0.91) were comparable in both groups. PAPS patients and controls had similar PWV (9.07 ± 1.08 m/s vs 9.42 ± 1.47 m/s, p = 0.34) as well as echo tracking parameters such as intima-media thickness (683 ± 171 µm vs 636 ± 140 µm, p = 0.52), carotideal diameter (p = 0.26), distensibility (p = 0.92), compliance coefficients (p = 0.36) and elastic modulus (p = 0.78). Patients with exclusively venous thrombosis showed lower PWV than patients with arterial thrombosis (8.55 ± 0.70 m/s vs 9.56 ± 0.94 m/s, p = 0.01), but no difference regarding intima-media thickness (683 ± 171 µm vs 636 ± 140 µm, p = 0.52) was observed.
  
  
  CONCLUSIONS
  Patients with PAPS do not seem to be at higher risk of developing premature atherosclerosis. Patients who suffered exclusively venous thrombosis seem to be at lower risk than those with exclusively arterial events. Other studies need to confirm our findings.
authors.affiliation: Rheumatology Division, São Paulo University, São Paulo, Brazil danieli.andrade@hc.fm.usp.br.
authors.forename: D
authors.initials: D
authors.lastname: Andrade
authors.affiliation: Heart Institute of São Paulo University, São Paulo, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Bortolotto
authors.affiliation: Rheumatology Division, São Paulo University, São Paulo, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Bonfá
authors.affiliation: Rheumatology Division, São Paulo University, São Paulo, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Borba
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology*; D050197:Atherosclerosis / Q000175:diagnosis / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology*
chemical_list: D017152:Antibodies, Antiphospholipid; D015415:Biomarkers
keywords: Antiphospholipid syndrome; atherosclerosis; coronary artery disease; pulse wave analysis; ultrasonography