Increased prevalence of subclinical atherosclerosis in patients with small vessel vasculitis

Gilles Chironi ¹, Christian Pagnoux ², Alain Simon ^1*, Maria Pasquinelli-Balice ¹, Muriel Del-Pino ¹, Jérôme Gariepy ¹ and Loïc Guillevin ²

¹ Hôpital Broussais-HEGP, Université Paris V, France
² Hôpital Cochin, Université Paris V, France

^* To whom correspondence should be addressed. E-mail: alain.simon{at}brs.ap-hop-paris.fr.

Accepted 7 August 2006

Abstract

Objective To bring additional arguments supporting that medium- sized and small vessel vasculitis may promote atherosclerosis, because although the alterations of smaller vessels are its hallmark, coexisting risk factors and/or systemic inflammation may also impair large arteries.

Design, setting and patients Fifty consecutive patients with primary systemic necrotizing vasculitis and 100 age- and sex- matched controls 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 subjects, and diagnosis of high-risk status was defined by the presence of known history of cardiovascular disease, type 2 diabetes, and/or 10 year- Framingham risk score at or above 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 disease was associated with higher frequency of three- vessels plaque (p<0.05) independently of high-risk status and CRP. In patients group, higher frequency of three- vessels plaque was associated with high-risk status (p<0.05) but not with CRP, nor with 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.

Keywords: Atherosclerosis, Inflammation, Plaque, Ultrasonics, Vasculitis

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