Increased prevalence of subclinical atherosclerosis in patients with small- vessel vasculitis
Increased prevalence of subclinical atherosclerosis in patients with small- vessel vasculitis
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DOI：
10.1136/hrt.2006.088443
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发表时间：
2007-01-01
期刊：
影响因子：
5.7
通讯作者：
Guillevin, L.
中科院分区：
文献类型：
--
作者：
Chironi, G.;Pagnoux, C.;Guillevin, L.
背景和目的：虽然小血管的改变是中小血管炎的标志，但有研究表明，由于共存的危险因素或全身性炎症，这类患者的大动脉也可能受到早期动脉粥样硬化过程的影响。这项研究旨在为支持这一假设提供更多的论据。设计、环境和患者：连续50例原发性全身性坏死性血管炎患者和100例年龄和性别匹配的对照组，对3条周围血管（颈动脉、股动脉和腹主动脉）的斑块进行超声检测。同时测量所有参与者的心血管危险因素和炎症（C反应蛋白（CRP）），并通过存在已知的心血管疾病史、2型糖尿病或10年framingham风险评分>= 20%来定义高危状态的诊断。结果：患者颈动脉斑块频率高于对照组（p < 0.05）、主动脉斑块频率高于对照组（p < 0.01）、三支血管斑块频率高于对照组（p < 0.001），高危状态调整并没有混淆主动脉斑块和三支血管斑块的差异。在患者和对照组的总体人群中，血管炎与三支血管斑块的较高频率相关（p < 0.05），与高危状态和CRP无关。在患者中，三支血管斑块的较高频率与高危状态相关（p < 0.05），但与CRP、疾病和治疗特征无关。结论：小血管炎与更频繁的亚临床动脉粥样硬化相关，尤其是扩展到多根外周血管，这种关联不能完全用心血管危险因素和全身炎症来解释。
Background and objective: Although changes in smaller vessels is the hallmark of medium-sized and small-vessel vasculitis, it has been suggested that large arteries of such patients may also be affected by the early atherosclerotic process because of coexisting risk factors or systemic inflammation. This study aimed to bring additional arguments supporting this hypothesis.Design, setting and patients: 50 consecutive patients with primary systemic necrotising vasculitis and 100 controls matched for age and sex 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 participants, and diagnosis of high-risk status was defined by the presence of known history of cardiovascular disease, type 2 diabetes or 10-year-Framingham Risk Score >= 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 was associated with a higher frequency of three-vessel plaques ( p < 0.05), independently of high-risk status and CRP. In patients, the higher frequency of three-vessel plaques was associated with high-risk status ( p < 0.05) but not with CRP, or 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.