FRI0381 Are the antiphospholipid antibodies a “new” independent risk factor for accelerated atherosclerosis
Authors: N. Stoilov, V. Boyadzhieva, R. Rashkov, S. Stefanov
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The physiological function of phospholipids and their protein co-factors, which are aPL target, are well known. Beta 2 glycoprotein 1 is an important transport molecule that binds negatively charged particles to free circulation, including various lipoproteins, such as LDL. In this context, β2GPI plays the role of protein co-factor of low density lipoprotein and is a key factor affecting serum levels of free LDL and total cholesterol, respectively. Its physiological function is suppressed by antibodies against it. <h3>Objectives</h3> We investigated the incidence of atherosclerosis in patients with antiphospholipid syndrome compared with systemic lupus erythematosus without aPL and healthy controls at pre-treatment sites. <h3>Methods</h3> We examined 219 people devided in three groups – APS (136), SLE,<sup>42</sup> healthy controls.<sup>41</sup> We performed an ultrasound examination of the carotid arteries, measuring intima-media thicknes as well and evaluate the vessel wall for atherosclerotic plaques. We performed calcium score on the coronary arteries, aorta and aortic valve as well. <h3>Results</h3> Between our groups we do not foud statistically significant differece for BMI. Comparative analysis for LDL-cholesterol showed higher APS median values (3.13 mmol/L) compared to other groups. Using the Kruskal-Wallis test, we have a statistically significant result for a direct correlation with the antiphospholipid syndrome (p=0.001). Patients with APS shows higher levels for LDL. With the Kruskall-Wallis analysis, we found a statistically significant difference in IMT between the study groups for left (p=0.005) and right (p=0.014) carotid arteries. With Mann-Whitney analysis, we do not detect statistically significant differences in IMT values between patients with primary antiphospholipid syndrome and those with secondary. We investigated the frequency distribution of atherosclerotic plaques in individuals in the groups. In the right carotid artery, plaque was found in 18 (31.6%) patients with APS, 3 (7.3%) cases were recorded in healthy controls, and in the SLE group there were no reported cases. We establish a statistically significant correlation of carotid plaques in APS oatients (p≤0.001). In our study group of patients with APS is characterised by the highest incidence of positive CaScore, and its maximum values are significantly higher than the other two groups. The maximum Agatson score for patients with antiphospholipid syndrome is 908 HU, with SLE being 2.1 HU, with healthy controls – 233HU. We ivestigate the levels of anti-ox LDL antibodies and we found that there is a correlation between the levels of aPL and anti-oxLDL. <h3>Conclusions</h3> The conclusion from our study is that the aPL could cosidered for independent risk factor for accelerated atherosclerosis. The aPL are responsible for dyslipidemia in some cases blocking the transport molecules like b2GPI. <h3>Disclosure of Interest</h3> None declared