Bello Federica, Bettiol Alessandra, Silvestri Elena, Mattioli Irene, Urban Maria Letizia, Palermo Adalgisa, Mazzetti Matteo, Malandrino Danilo, Calcaterra Ilenia, Vaglio Augusto, Di Minno Matteo Nicola Dario, Emmi Giacomo, Prisco Domenico
Department of Experimental and Clinical Medicine, University of Florence, Florence.
Department of Clinical Medicine and Surgery, Federico II University, Naples.
Rheumatology (Oxford). 2023 Feb 1;62(2):835-840. doi: 10.1093/rheumatology/keac427.
Patients affected by eosinophilic granulomatosis with polyangiitis (EGPA) display an increased risk of atherothrombotic events compared with the general population. An increased frequency of subclinical markers of atherosclerosis has been observed in other ANCA-associated vasculitis, but no specific study focused on EGPA. We therefore evaluated subclinical atherosclerosis in EGPA patients and in a control population.
Forty EGPA patients and 80 controls matched by age, sex and traditional cardiovascular risk factors underwent sonographic assessment of common carotid artery (CCA) intima-media thickness (IMT). The presence of plaques of the CCA was also investigated. The correlation between CCA-IMT and clinical and laboratory features was also assessed.
Median CCA-IMT was significantly higher in EGPA patients compared with controls (P = 0.002). Also, the proportion of subjects with increased CCA-IMT and with presence of plaques was significantly higher among EGPA patients (P < 0.001 for both). Moreover, within the EGPA cohort, CCA-IMT tended to increase with disease duration (P = 0.034) and corticosteroid cumulative dose (P = 0.004). No significant associations were found between CCA-IMT, ANCA status, other clinical features and therapeutic regimens. Notably, the prevalence of traditional cardiovascular risk factors was comparable in patients with vs without an increased CCA-IMT.
Ultrasound markers of subclinical atherosclerosis are increased in EGPA patients as compared with controls, independently of traditional cardiovascular risk factors.
与普通人群相比，嗜酸性肉芽肿性多血管炎（EGPA）患者发生动脉粥样血栓形成事件的风险增加。在其他抗中性粒细胞胞浆抗体（ANCA）相关血管炎中已观察到动脉粥样硬化亚临床标志物的频率增加，但尚无针对EGPA的具体研究。因此，我们评估了EGPA患者和对照人群中的亚临床动脉粥样硬化情况。
40例EGPA患者和80例年龄、性别及传统心血管危险因素相匹配的对照者接受了颈总动脉（CCA）内膜中层厚度（IMT）的超声评估。还调查了CCA斑块的存在情况。同时评估了CCA-IMT与临床及实验室特征之间的相关性。
与对照组相比，EGPA患者的CCA-IMT中位数显著更高（P = 0.002）。此外，EGPA患者中CCA-IMT增加和存在斑块的受试者比例也显著更高（两者均P < 0.001）。此外，在EGPA队列中，CCA-IMT倾向于随疾病持续时间（P = 0.034）和皮质类固醇累积剂量（P = 0.004）增加。在CCA-IMT、ANCA状态、其他临床特征和治疗方案之间未发现显著关联。值得注意的是，CCA-IMT升高与未升高的患者中传统心血管危险因素的患病率相当。
与对照组相比，EGPA患者亚临床动脉粥样硬化的超声标志物增加，且独立于传统心血管危险因素。
