POS1139 COMPARISON OF THE FREQUENCY OF DETECTION OF EARLY SIGNS OF ATHEROSCLEROSIS IN PATIENTS WITH CALCIUM PYROPHOSPHATE CRYSTAL DEPOSITION DISEASE AND OSTEOARTHRITIS
Authors: M. Elisеev, A. Novikova, O. Sheliabina, M. Chikina, E. Markelova
Journal: Annals of the Rheumatic Diseases (2021)

Background: Crystal-induced inflammation can significantly increase cardiovascular risk (CVR) and cause early development of atherosclerosis [1]. However, no studies have been performed in patients with calcium pyrophosphate crystal deposition disease (CPPD). Objectives: To compare the presence of atherosclerosis early signs (increased thickness of the intima-media complex (CIMT)) in patients with CPPD and osteoarthritis (OA). Methods: A cross-sectional study included 48 patients, aged 18 to 65 years, 26 patients with crystal-verified diagnosis of CPPD (McCarty criteria) (6 (23%) men and 20 (77%) women) and 22 patients with OA (7 (32%) men and 15 (68%) women). Exclusion criteria are the presence of other rheumatic diseases with symptoms of arthritis, diabetes mellitus, coronary heart disease (CHD), prior myocardial infarction, stroke or myocardial revascularization surgery, estimated glomerular filtration rate (eGFR) &lt;60 ml/min/1.73 m2, high and very high CVR on the SCORE scale. The examination of the patients included the history taking, assessment of anthropometric parameters and the following laboratory tests: determination of serum creatinine level (eGFR according to the MDRD formula), total cholesterol (TC), high density lipoprotein cholesterol (HDL cholesterol) and low density lipoprotein cholesterol (LDL cholesterol), C-reactive protein (CRP). Doppler ultrasound of the carotid arteries with an assessment of the thickness of the intima media complex (CIMT) was made for all patients - CIMT up to 0.9 mm was taken as the norm, CIMT&gt; 0.9 mm and &lt;1.3 mm as increased, and CIMT&gt;1.3 mm was regarded as an atherosclerotic plaque. Statistica 12.0 package was used for statistical data processing. Results: The groups were completely comparable by gender, age and all laboratory parameters (see Table 1), an increase in CRP&gt;5 mg/l was more often detected in patients with CPPD - 31% vs 14% patients with OA (p=0.16). Table 1. Clinical characteristics of patients included in the study. Parameters CPPD (n=26) OA (n=22) p value (reliable at р&lt;0,05) Age, years M±SD 55.9±5.9 52.4±8.3 0.14 Gender, men/women,n (%) 6 (23)/20 (77) 7 (32)/15 (68) 0.50 Smoking, n (%) 5(19) 6(27) 0.50 Systolic blood pressure, mmHg, M±SD 134±20 127±15 0.19 Arterial hypertension, n (%) 13(50) 10(45) 0.75 Family history of CVD, n % 6(23) 7(32) 0.50 TC, mmol/L, M±SD 5.4±1.3 5.3±1.3 0.95 TC &gt;5,0 mmol/L, n (%) 17(65) 10(45) 0.17 HDL, mmol/L M±SD 1.7±0.5 1.4±0.5 0.10 LDL, mmol/L, M±SD 2.9±1.3 3.4±1.4 0.33 Creatinine, μmol/l, M±SD 73.2±13.8 78.9±11.5 0.16 CRP, mg/l, Me [25-75th percentiles] 1.1 [0.6; 6.4] 1.2 [0.3; 2.8] 0.60 CRP ≥5 mg/l, n (%) 8 (31) 3(14) 0.16 Mean CIMT values on the right (0.76±0.22 mm vs 0.70±0.18 mm) and on the left (0.75±0.18 mm vs 0.70±0.17 mm) did not significantly differ in CPPD and OA (p=0.34 and 0.32, respectively), the maximum CIMT values on the right (0.67±0.16 mm vs 0.67±0.16 mm) and on the left (0.67±0.14 mm vs 0,66±0.16 mm) with CPPD and OA were also comparable (p=0.95 and 0.77, respectively). However, an increase in CIMT&gt; 0.9 mm was found in 13 (50%) patients with CPPD and only 5 (23%) with OA (p=0.02). No increase in CIMT&gt;1.3 mm was found in patients of both groups. Conclusion: Early signs of atherosclerosis are detected in 50% of patients with CPPD without clinical signs of atherosclerosis and with low or moderate CVR according to SCORE, significantly more often than in patients with OA (23%), which can be reflection of chronic crystal-induced inflammation. References: [1]Hoseini Z, Sepahvand F, Rashidi B, Sahebkar A, Masoudifar A, Mirzaei H. NLRP3 inflammasome: Its regulation and involvement in atherosclerosis. J Cell Physiol. 2018 Mar;233(3):2116-2132. doi: 10.1002/jcp.25930. Epub 2017 May 23. PMID: 28345767. Disclosure of Interests: Maxim Elisеev Speakers bureau: Berlin Chemie Menarini Group, Novartis International AG, EGIS, Aleksandra Novikova: None declared, Olga Sheliabina: None declared, Maria Chikina: None declared, Eugenia Markelova: None declared.