Carotid Intima-Media Thickness and Anti-Phospholipid Antibodies in Patients with Systemic Lupus Erythematosus

Abstract

An increase in mortality due to accelerated atherosclerosis has been reported in patients affected with Systemic Lupus Erythematosus (SLE). Anti-phospholipid antibodies (aPA) may play a pathogenetic role in the development of atherosclerosis. We measured carotid intima-media thickness (IMT), as a surrogate parameter of atherosclerosis, by B-mode ultrasound examination in 42 patients affected with SLE (11 men and 31 women) and in 42 healthy age- and sex-matched subjects. Lupus Anticoagulant (LA) (APTT sensitive, silica clotting time, DRVVT), Anti-cardiolipin antibodies (ACA) IgG and IgM, anti-β2glycoprotein 1 (anti-β2GP1) IgG and IgM and anti-prothrombin (anti-PT) IgG and IgM in ELISA (Orgentec Bouty) were also detected. IMT was 0.538±0.128 mm (0.310–0.866 mm) in SLE vs 0.473±0.084 mm in healthy subjects (-p 0.003–). IMT correlated with patients’ age (p0.600 mm and 33.3% in those with IMT 0.600 mm and 23.3% in patients with IMT 0.7 mm, 2 had LA positivity (40%) vs 10/37 (27%) of those with minor carotid thickness. In conclusion, IMT, a surrogate parameter of atherosclerosis, was correlated with Patients’ age and CRP and not with presence of aPA, even though, in the group of patients with greater IMT, there was a non-significant higher proportion of positivity for anti-phospholipid antibodies, in particular for Lupus Anticoagulant.