P016\u2005Vascular involvement in rheumatic diseases – the role of imaging and immunological biomarkers

Abstract

Career situation of first and presenting author Assistant. Introduction Vascular abnormalities are common complications in rheumatic patients. Their background is multifactorial and still is a subject of the debate. Objectives This study was designed to evaluate the significance of selected noninvasive imaging indices, immunological and genetic biomarkers in diagnosis of vascular lesions in rheumatic diseases. Methods The study group included 288 patients with systemic connective tissue diseases (SCTD). The noninvasive evaluation of vascular lesions was made on the basis of carotid intima-media thickness (cIMT), ankle brachial index (ABI), high resistance index (HRI) and ulnar artery intraluminal diameter (UAID) measurements using HDI 3500 (ATL). We analyzed more than 100 variables: autoantibodies, inflammatory and angiogenic markers, genetic polymorphisms and classical risk factors for atherosclerosis. Statistical analysis was performed with STATA 11 including: chi2Yates, chi2Pearson and rank Spearman correlations tests, logistic regression analysis and multivariate stepwise analysis. Results Macroangiopathy was influenced by selected autoantibodies including antiphospholipid (OR=4.4; 95%\u2009CI:1.1–20.7) and anti-endothelial cell (OR=6.6; 95%\u2009CI:1.6–28.3) as well as inflammatory biomarkers (OR=3.6; 95%\u2009CI:1.1–11.8). The analysis of genetic polymorphisms showed especially an important impact of VEGF 2578 AA genotype on atherosclerosis development (OR=4.8; 95%\u2009CI:1.1–21.1). Angiogenic biomarkers were strongly associated with prothrombotic risk (OR=22.8; 95%\u2009CI:2.3–230.6). The analysis of relations between imaging indices and vascular manifestations revealed significant association of cIMT with cardiovascular (OR=52.9; 95%\u2009CI:7.0–1012.7) and cerebrovascular disease (OR=4.0; 95%\u2009CI:1.0–15.3). There was significant reverse correlation between ABI and peripheral vascular disease (R=−0.33; p=0.001). HRI values significantly correlated with thromboembolic disorders (R=−0.29; p=0.03). Finaly, UAID was notably related to microangiopathic complications (p<0.05). Conclusions The protocol for vascular lesions diagnosis in SCTD should be based on the combination of imaging and laboratory biomarkers. Immunological and inflammatory factors are crucial in diagnostics of vascular involvement in rheumatic diseases. IMT and ABI showed a high prognostic value and can be used for the general cardiovascular risk stratification. Disclosure of Interest None declared.