Key result
Thrombotic antiphospholipid syndrome is linked to increased arterial stiffness on AIx@75 versus healthy controls.
Why the study?
Cardiovascular disease is a major cause of morbidity and mortality in antiphospholipid syndrome, but arterial stiffness and its predictors in thrombotic antiphospholipid syndrome had not been assessed against controls.
Does thrombotic antiphospholipid syndrome increase arterial stiffness compared to healthy controls and diabetes mellitus patients?
Observational (n=330)
Does thrombotic antiphospholipid syndrome increase arterial stiffness compared to healthy controls and diabetes mellitus patients?
Effect estimate: β 4.525 (95% CI 1.372, 7.677)
p-value: p=0.005
Patients with thrombotic antiphospholipid syndrome exhibit elevated AIx@75 similar to diabetes mellitus patients, indicating enhanced arterial stiffening that may aid in cardiovascular risk stratification.
May aid CV risk stratification in thrombotic APS similar to diabetes; hypothesis-generating and requires prospective confirmation.
OBJECTIVES: Cardiovascular disease is a major cause of morbidity and mortality in Antiphospholipid syndrome (APS). Arterial stiffness (ArS) has emerged as a predictor of future cardiovascular events in the general population. We aimed to assess ArS in patients with thrombotic APS versus diabetes mellitus (DM) and healthy controls (HC) and identify predictors of increased ArS in APS. METHODS: ArS was evaluated by carotid-femoral pulse wave velocity (cfPWV) and augmentation index normalized to 75 beats/min (AIx@75) using the SphygmoCor device. Participants also underwent carotid/femoral ultrasound for atherosclerotic plaque detection. We used linear regression to compare ArS measures among groups and assess ArS determinants in the APS group. RESULTS: We included 110 patients with APS (70.9% female, mean age 45.4 years), 110 DM patients and 110 HC, all age/sex matched. After adjustment for age, sex, cardiovascular risk factors and plaque presence, APS patients exhibited similar cfPWV [β = -0.142 (95% CI -0.514, 0.230), p = 0.454] but increased AIx@75 [β = 4.525 (95% CI 1.372, 7.677), p = 0.005] compared with HC and lower cfPWV (p < 0.001) but similar AIx@75 (p = 0.193) versus DM patients. In the APS group, cfPWV was independently associated with age [β = 0.056 (95% CI 0.034, 0.078), p < 0.001], mean arterial pressure (MAP) [β = 0.070 (95% CI 0.043, 0.097), p < 0.001], atherosclerotic femoral plaques [β = 0.732 (95% CI 0.053, 1.411), p = 0.035] and anti-β2-glycoprotein I IgM positivity [β = 0.696 (95% CI 0.201, 1.191), p = 0.006]. AIx@75 was associated with age [β = 0.334 (95% CI 0.117, 0.551), p = 0.003], female sex [β = 7.447 (95% CI 2.312, 12.581), p = 0.005] and MAP [β = 0.425 (95% CI 0.187, 0.663), p = 0.001]. CONCLUSION: APS patients exhibit elevated AIx@75 vs HC and similar to DM patients, indicating enhanced arterial stiffening in APS. Given its prognostic value, ArS evaluation may help to improve cardiovascular risk stratification in APS.
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Evangelatos et al. (2023) conducted an observational in Antiphospholipid syndrome (n=330). Antiphospholipid syndrome vs. Diabetes mellitus and healthy controls was evaluated on Augmentation index normalized to 75 beats/min (AIx@75) compared to healthy controls (β 4.525, 95% CI 1.372, 7.677, p=0.005). Patients with thrombotic antiphospholipid syndrome exhibited increased arterial stiffness measured by AIx@75 compared with healthy controls (β 4.525; 95% CI 1.372-7.677; p=0.005).
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