4.0 Article

A pilot study of subclinical coronary atherosclerosis in systemic sclerosis: Coronary artery calcification in cases and controls

Journal

ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
Volume 59, Issue 4, Pages 591-597

Publisher

WILEY-LISS
DOI: 10.1002/art.23540

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Funding

  1. NIAMS NIH HHS [K23-AR053858-01A1, R01-AR50797, T32AR07594] Funding Source: Medline
  2. NICHD NIH HHS [HD051953] Funding Source: Medline

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Objective. Systemic sclerosis (SSc) is associated with vasculopathy and endothelial cell injury, which could potentially increase the risk of coronary atherosclerosis. Multidetector computed tomography, a noninvasive procedure, generates a coronary calcium score (CCS) as a marker for coronary atherosclerosis. Serum proinflammatory high-density lipoprotein (piHDL) is a potential novel marker of atherosclerotic risk. The objective of the pilot study was to determine 1) the prevalence of subclinical coronary atherosclerosis in SSc and 2) serum piHDL levels as a potential novel marker of atherosclerotic risk in SSc. Methods. A cross-sectional study of 17 patients with SSc and 17 age-, sex-, and race-matched healthy controls in Cincinnati, Ohio, was conducted. Measurements included CCS; body mass index; lipid profile; and serum levels of high-sensitivity C-reactive protein, homocysteine, and piHDL. Results. Patients with SSc were slightly older (mean 52.8 years) than control subjects (mean 50.6 years; P = 0.01). Coronary calcium was found in 12 participants (9 with SSc, 3 controls; P = 0.03). The mean +/- SD CCS in patients with SSc was significantly greater than the controls (126.6 +/- 251.0 versus 14.7 +/- 52.2; P = 0.003). Five patients with SSc (29%), but no controls, had detectable levels of piHDL (P = 0.06). Conclusion. Prevalence of subclinical coronary atherosclerosis is greater in patients with SSc compared with healthy controls. These findings should be confirmed in a larger study.

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