AB1367 RELATIONSHIP BETWEEN CAPILLAROSCOPIC FINDINGS AND CARDIOVASCULAR RISK FACTORS
Authors: E. Alvarez Andres, M. J. García de Yébenes, L. Carmona, E. De Miguel, P. Collado, P. García de la Peña
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Capillaroscopy is a non-invasive technique that observes the capillaries of the nail bed, used in the study of patients with Raynaud's phenomenon (RP), that helps in the diagnosis of certain rheumatological diseases. On the other hand, one of the main causes of mortality in this disorders are cardiovascular diseases, so the control of cardiovascular risk factors (CVRF) have special relevance. <h3>Objectives:</h3> The main objective of the study was to demonstrate that CVRF (diabetes (DM), tobacco (TOB), alcohol (ALC), obesity (OBE), dyslipidemia (DL) and arterial hypertension (HTA)) produce alterations in capillaroscopy independently of the presence of RP and rheumatological diseases. As a secondary objective, we evaluated the possible association between capillaroscopy findings and carotid ultrasound. <h3>Methods:</h3> Cross-sectional study carried out in a public hospital in Madrid from January 2019 to January 2023. CP was performed with a 200x videocapillaroscope (Dinolite) and images analyzed with DinoXcope software (1.15). A HITACHI ultrasound with vascular preset and 2.5 MHz was used. Variables were collected: sociodemographic, CVRF (TOB, ALC, DM, HTA, DL and OBE), rheumatological diseases, RP, treatments, capillaroscopy´s alterations: tortuosities (TOR), ramifications (RAM), dilations (DIL) (&gt;20µm), giant capillaries (&gt;50µm), hemorrhages (HEM), avascular areas (AA) and venous plexus; intima media thickness and atheromatous plaque in carotid ultrasound. To perform the statistical analysis, 4 groups were made: rheumatological diseases with RP, rheumatological diseases without RP, RP without rheumatological diseases, and without RP and without rheumatological diseases (the study group). In these groups, frequency/percentage of CP findings was calculated globally and for each CVRF, using bivariate and multivariate logistic regression models. A model was built for each of the capillaroscopic findings (dependent variable). The main independent variable or study factor was CVRF. The variables RP and rheumatological disease were kept in the models to control their possible confusion effect. <h3>Results:</h3> 402 subjects were included, 76% women, mean age 51±16 years. 50% with RP and 38% with rheumatological diseases. 67% of subjects had a single CVRF. In all groups, subjects with CVRF presented a high frequency of capillaroscopy alterations, especially TOR (100%), RAM (82 -97%) and DIL (69-93%). In the group of study, all subjects with CVRF presented TOR, and we find RAM in 100% of subjects with HTA or DL, 90% with TOB, ALC o DM and 75% of OBE. The factors associated with RAM were CVRF (OR=95.6), age (OR=1.03), corticosteroids (OR=5.5), anti-inflammatory (OR=7.55), antihypertensive (OR=7.9), statins (OR=14.6) and antiplatelets (OR=9.03). DIL was associated with CVRF (OR=59.2), age (OR=1.03), corticosteroids (OR=5.12), anti-inflammatory (OR=3.78), antihypertensive (OR=4.41), statins (OR=7.54) and antiplatelets (OR=4.97). Giant capillaries were associated with CVRFs (OR=8.32), rheumatological diseases (OR=8.49), and RP (OR=6.08). Subjects with HEM were older, with a higher frequency of CVRF (96% vs 54%) (OR=17.6), especially ALC (16%) and OBE (6%). There was asociation between AA and CVRF OR=14.4), especially with ALC and OBE. The multivariate analysis confirmed this association independently of RP and rheumatological diseases (OR=13.56). Regarding carotid ultrasound, 40 subjects presented plaques (9.9%), and asociation with CVRF (OR=22.6), RAM (OR=3.01), DIL (OR=8.08), HEM (OR=4.04),) and age (OR=1.10). We also found an association between pathological intima-media thickness and HEM (OR=3.14). <h3>Conclusion:</h3> There is a clear association between alterations in capillaroscopy and CVRF. This is of special interest for a correct interpretation and avoid false positive diagnosis of autoinmune diseases related with RP and opens the possibility of a new indication of capillaroscopy to assess cardiovascular damage. <h3>REFERENCES:</h3> [1] Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud's phenomenon and systemic sclerosis. Smith V et al, Autoimmun Rev 2020 Mar;19(3):102458. <h3>Acknowledgements:</h3> Rheumatology medical team of Severo Ochoa Hospital. <h3>Disclosure of Interests:</h3> <b>None declared.</b>