AB1362 CAN PATIENTS WITH CARDIOVASCULAR RISK FACTORS HAVE ALTERATIONS IN CAPILLAROSCOPY?
Authors: E. Alvarez Andres, L. Nuño, I. Losantos García, E. De Miguel, A. Balsa, P. Collado, P. García de la Peña
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Capillaroscopy (CP) is a non-invasive technique that allows observation of the capillaries in the nail bed, being a widely used tool in patients with Raynaud's phenomenon (RP) for the diagnosis of certain rheumatological diseases. On the other hand, one of the main causes of mortality in connective tissue diseases is heart disease and many patients have cardiovascular risk factors (CVRF): tobacco (TOB), diabetes (DM), alcohol (ALC), dyslipidemia (DL), arterial hypertension (HTA) and obesity. <h3>Objectives:</h3> The objective is to study whether there are characteristic capillaroscopic alterations in patients with CVRF and if cardiovascular risk can be a confounding factor when correctly classifying patients. <h3>Methods:</h3> Multicenter descriptive retrospective study based on clinical records from two public hospitals in the community of Madrid between 2015 and 2018. CP was performed with a 200x videocapillaroscope (Dinolite). Images were analyzed with DinoXcope software version 1.15. The variables were collected: CVRF, RP, pathologies and complications, laboratory data and autoimmunity, drug intake and alterations in CP (tortuosities, ramifications, dilations (&gt;20µm), giant capillaries (&gt;50µm) and hemorrhages). The statistical analysis consisted of parametric and non-parametric studies, obtaining statistical significance with p&lt;0.05. <h3>Results:</h3> 340 medical records were reviewed, 286 women and 54 men, with a middle age of 52.36 ± 16.971 years; 264 patients with RP (77.6%), 85 with triphasic color change of the digits (25%). We divide the patients into 3 groups: 155 healthy patients/primary RP (45.6%), 123 patients with sclerodermiform pathology (36.2%) and 62 patients with other non-sclerodermiform pathologies (18.2%). 212 patients (62.4%) had CVRF: 108 DL (31.8%), 62 HTA (18.2%), 59 exTOB (17.4%) and 49 TOB (14.4%), 20 DM (5.8%), 8 ALC (2.4%). Regarding changes in CP, a statistically significant association was observed in all groups between CVRF and tortuosity 99.5% (p&lt;0.001), especially with HTA 100% (p&lt;0.001), taking antihypertensives 100% (p&lt;0.001) and hypercholesterolemia (p=0.006). We also observed association between tortuosities and hyperemia 99.6% (p&lt;0.001) and the onset´s age of RP (p=0.008). Concerning the ramifications, there is an association in all groups with CVRF 86.8% (p&lt;0.001), especially HTA 82.3% (p&lt;0.001), TOB (p&lt;0.001) and hyperemia (p&lt;0.001). About dilations we found also an association in all groups with CVRF (p&lt;0.001), HTA (p=0.019) and TOB (p=0.004). Regarding giant capillaries, there is an association with TOB (p=0.034) and hyperemia (p&lt;0.001). In respect of hemorrages, there is an association with CVRF (p&lt;0.001), HTA (p= 0.008), TAB (p=0.002), hyperemia (p&lt;0.001) and antihypertensives (p=0.002). Concerning capillary loss, there is an association with HTA and antihypertensives intake. However, the visibility of the venous plexus did not present an association with CVRF. <h3>Conclusion:</h3> This study reveals the association between alterations in CP and CVRF. CP is a technique very used in Rheumatology but there is a limited literature regarding the alterations that can produce CVRF in CP. Prospective studies are needed to confirm the results of this study and see its applicability in clinical practice. <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 at Severo Ochoa Hospital. <h3>Disclosure of Interests:</h3> <b>None declared.</b>