AB0142 ANTIPHOSPHOLIPID SYNDROME AND ATHEROSCLEROSIS
Authors: N. Stoilov, V. Boyadzhieva
Journal: Annals of the Rheumatic Diseases (2020)

Background: Antiphospholipid syndrome (APS) is a systemic autoimmune disease with unknown etiology and complex pathogenesis. Recent studies have shown that the pathogenesis of the atherosclerotic process is related to the inflammatory component of the immune response, as well as to elements of autoimmunity. A number of autoimmune rheumatic diseases, including rheumatoid arthritis (RA), SLE and APS, are characterized by accelerated atherosclerosis and therefore at increased risk of cardiovascular disease and mortality. The risk of early atherosclerosis in patients with autoimmune disease is determined by traditional risk factors, chronic generalized inflammation, and target-specific autoimmune processes. These processes are complemented by the chronic use of drugs, such as KS, which worsen BMI, lead to hyperglycemia and hyperlipidemia. Objectives: The aim of this study is to investigate the incidence of atherosclerosis at selected typical sites in patients with APS. Methods: We examined 139 patients devided in to three groups: APS, SLE and healty controls. We performed US examination of carotid atheries with IMT measeurement and Calcium score of coronary artheries and aorta. All the patients were tested for: CBC, lipid panel, liver probes, ESR, anti-CL, anti-b2GPI anti-Prothrombin antibodies and ANA screen and ANA-profile as well. Results: 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. Comparative analysis between the groups showed that pathological levels of IMT (&gt; 900 µm) in the right carotid artery were the highest in patients with antiphospholipid syndrome 15 (26.3%). In healthy controls, 3 (7.3%) were identified and no cases were reported for patients with SLE. The data for the left carotid artery (LCCA) are similar. 15 (26.3%) were registered for AFS, 4 for healthy controls (9.2%), and no patients with pathological values for IMT were registered in the SLE group. We compared the results for intima-media ticking between groups with the Chi-square test, finding a statistically significant correlation for the two carotid arteries - IMT-RCCA p = &lt;0.001 for IMT-LCCA p = 0.002. Descriptive statistics show that the highest frequency of positive calcium score is characterized by the APS group 12 (31.6%), in patients with SLE they are 3 (15%), in healthy controls the case is 3%. In our study, the AFS group had the highest incidence of positive CaScore, and its maximum values were significantly higher than the other two groups. The maximum agatson score for patients with antiphospholipid syndrome is 908 HU (Hounsfield Units), for SLE it is 2.1 HU, for healthy controls it is 233HU. With the Kruskall-Wallis statistical analysis we examined the relationship of calcium score with the individual groups. Aortic aortic valve score was negative in all subjects. We find statistically significant differences between the calcium score groups. Conclusion: The APS group is statistically significant in both pathologic IMT and higher plaque incidence compared to healthy controls and patients with SLE without the presence of anthophospholipid antibodies. Based on the data obtained we can conclude that the antiphospholipid antibodies tested and their serum levels did not directly influence the values of the coronary artery and aortic Agatson score. Disclosure of Interests: None declared