PERIPHERAL VASCULAR DISEASE

Increased prevalence of subclinical atherosclerosis in patients with small-vessel vasculitis

G Chironi¹, C Pagnoux², A Simon¹, M Pasquinelli-Balice¹, M Del-Pino¹, J Gariepy¹, L Guillevin²

¹ Centre de Médecine Préventive Cardiovasculaire, Groupe Hospitalier Broussais-HEGP, Université Paris V, Paris, France
² Service de Médecine Interne, Hôpital Cochin, Université Paris V, Paris, France

Correspondence to:
Professor A Simon
Centre de Médecine Préventive Cardiovasculaire, Hôpital Broussais, 96 rue Didot, 75674 Paris, France; alain.simon{at}brs.ap-hop-paris.fr

Background and objective: Although changes in smaller vessels is the hallmark of medium-sized and small-vessel vasculitis, it has been suggested that large arteries of such patients may also be affected by the early atherosclerotic process because of coexisting risk factors or systemic inflammation. This study aimed to bring additional arguments supporting this hypothesis.

Design, setting and patients: 50 consecutive patients with primary systemic necrotising vasculitis and 100 controls matched for age and sex underwent ultrasonic detection of plaque in three peripheral vessels (carotid and femoral arteries and abdominal aorta). Cardiovascular risk factors and inflammation (C reactive protein (CRP)) were concomitantly measured in all participants, and diagnosis of high-risk status was defined by the presence of known history of cardiovascular disease, type 2 diabetes or 10-year-Framingham Risk Score 20%.

Results: Patients had higher frequency of plaque than controls in the carotid arteries (p<0.05), in the aorta (p<0.01) and in the three vessels examined (p<0.001), and adjustment for high-risk status did not confound such difference in the aorta and in the three vessels. In the overall population of patients and controls, vasculitis was associated with a higher frequency of three-vessel plaques (p<0.05), independently of high-risk status and CRP. In patients, the higher frequency of three-vessel plaques was associated with high-risk status (p<0.05) but not with CRP, or disease and treatment characteristics.

Conclusions: Small-vessel vasculitis is associated with more frequent subclinical atherosclerosis, especially extended to multiple peripheral vessels, and such association is not entirely explained by cardiovascular risk factors and systemic inflammation.

Abbreviations: CRP, C reactive protein; IMT, intima–media thickness

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Lopes-Virella, M. F., Carter, R. E., Gilbert, G. E., Klein, R. L., Jaffa, M., Jenkins, A. J., Lyons, T. J., Garvey, W. T., Virella, G., and the DCCT/EDIC Cohort Study Group, (2008). Risk Factors Related to Inflammation and Endothelial Dysfunction in the DCCT/EDIC Cohort and Their Relationship With Nephropathy and Macrovascular Complications. Diabetes Care 31: 2006-2012 [Abstract] [Full Text]  
• Lee, S. J., On, Y. K., Lee, E. J., Choi, J. Y., Kim, B.-T., Lee, K.-H. (2008). Reversal of Vascular 18F-FDG Uptake with Plasma High-Density Lipoprotein Elevation by Atherogenic Risk Reduction. JNM 49: 1277-1282 [Abstract] [Full Text]