P1.08 DETERMINANTS OF VASCULAR DAMAGE IN SYSTEMIC LUPUS ERITHEMATOSUS

Abstract

Background: Systemic Lupus Erithematosus (SLE) is associated with increased cardiovascular risk and early vascular aging. The aim of the study was to evaluate aortic and carotid stiffness, central blood pressure (BP) and wave reflection in women with SLE, in order to identify whether different vascular districts are similarly influenced by disease duration, activity and organ damage. Methods: Medical and pharmacological history were collected. Disease activity and organ damage were evaluated by ECLAM e SLICC/ACR-DI scores, respectively. Pulse Wave Velocity (PWV) and Augmentation Index (AI) were acquired by applanation tonometry, whereas carotid intima-media thickness (IMT) and stiffness were obtained by an automated image analysis system. Results: 46 SLE women were enrolled (age 41±10years, BP 116±16/76±9 mmHg). Mean disease duration was 17±9years, ECLAM 0,9±1, SLICC 0,9±1,5. PWV(7,4±1,5 m/s) was related to age (r=0.52, p<0,001), mean BP (r=0.59, p<0.001), SLICC (r=0.44, p=0,01). AI (22,5±10,6%) was related to age (r=0.58,p<0,001), mean BP (r=0.50,p<0.001), SLICC (r=0.60,p<0,001), cumulative corticosteroid dose (CCD,r=0.40,p=0.03). Carotid IMT was related only to age (r=0.45, p=0.006). Carotid stiffness was related to age(r=0.68,p<0.001), AI (r=0.54,p<0.001), disease duration (r=0.45,p<0.03), CCD (0.52, 0.01). In multiple regression models adjusted for confounders, SLICC remained an independent predictor of PWV (p=0.04,r2=0.13) and AI (p=0.04, r2=0.16). Conversely, CCD (p<0.001,r2=0.25) and SLICC (p=0.02,r2=0.01) were independent predictors of carotid stiffness. Conclusions: In a cross-sectional analysis of a cohort of SLE patients, increased arterial stiffness and wave reflection are independently associated with disease-specific organ damage, but not with disease activity or duration; carotid stiffness is also selectively compromised by chronic corticosteroid use.