Increased carotid artery intima-media thickness as an indicator of the onset of atherosclerosis in patients with connective tissue systemic diseases

Abstract

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.
Aim: 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.