Increased Prevalence of Symptomatic Macrovascular Disease in Systemic Sclerosis

Overview

Journal Ann Rheum Dis

Specialty Rheumatology

Date 1995 Oct 1

PMID 7492228

Citations 26

Authors

D J Veale

T A Collidge

J J Belch

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine the prevalence of symptomatic macrovascular disease, as defined by the World Health Organisation questionnaire for intermittent claudication, in patients with systemic sclerosis (SSc), and to compare the prevalence in this population with a cross sectional population study group reported in the Edinburgh Artery Study (EAS).

Methods: A group of 53 patients with a diagnosis of limited or diffuse systemic sclerosis were identified from our register. They were asked to complete the WHO questionnaire to establish the presence or absence of intermittent claudication. In addition, each patient's case notes were reviewed to establish the existence of definite peripheral vascular disease and to determine their risk factor profile.

Results: Forty six patients responded to the questionnaire, giving a response rate of 87%. Intermittent claudication was found in 10 SSc patients (21.7%) according to the questionnaire (two with diffuse and eight with limited SSc), compared with a prevalence rate of 4.6% for claudication in the EAS. Three SSc patients experienced clinical events attributable to occlusion of a major artery proven on angiography. Four patients had hypertension, there were three current and four ex-smokers, and two had increased total cholesterol. None of these patients had diabetes.

Conclusions: This study demonstrated a greater prevalence of macrovascular disease in patients with SSc than had been found in a neighbouring population.

Citing Articles

Cardiovascular Risk Factors and Atherosclerotic Cardiovascular Events Among Incident Cases of Systemic Sclerosis: Results From a Population-Based Cohort (1980-2016).

Kurmann R, Sandhu A, Crowson C, Matteson E, Osborn T, Warrington K Mayo Clin Proc. 2020; 95(7):1369-1378.

PMID: 32622445 PMC: 9719716. DOI: 10.1016/j.mayocp.2019.12.015.

Study of MRI brain findings and carotid US features in systemic sclerosis patients, relationship with disease parameters.

Gamal R, Abozaid H, Zidan M, Abdelmegid M, Abdel-Razek M, Alsayed S Arthritis Res Ther. 2019; 21(1):95.

PMID: 30987675 PMC: 6466742. DOI: 10.1186/s13075-019-1877-z.

Neurosonological and cognitive screening for evaluation of systemic sclerosis patients.

Sakr B, Rabea R, Aboulfotooh A, Kishk N Clin Rheumatol. 2019; 38(7):1905-1916.

PMID: 30806858 DOI: 10.1007/s10067-019-04468-7.

Atherosclerosis in Systemic Sclerosis: a Modern Controversy.

Magda S, Mincu R, Mihai C, Cinteza M, Vinereanu D Maedica (Bucur). 2017; 10(3):248-256.

PMID: 28261362 PMC: 5327830.

Thrombotic complications after radial arterial line placement in systemic sclerosis: A case series.

Paik J, Hirpara R, Heller J, Hummers L, Wigley F, Shah A Semin Arthritis Rheum. 2016; 46(2):196-199.

PMID: 27139167 PMC: 5035550. DOI: 10.1016/j.semarthrit.2016.03.015.

References

DAngelo W, Fries J, MASI A, SHULMAN L . Pathologic observations in systemic sclerosis (scleroderma). A study of fifty-eight autopsy cases and fifty-eight matched controls. Am J Med. 1969; 46(3):428-40. DOI: 10.1016/0002-9343(69)90044-8. View

Youssef P, Englert H, Bertouch J . Large vessel occlusive disease associated with CREST syndrome and scleroderma. Ann Rheum Dis. 1993; 52(6):464-6. PMC: 1005074. DOI: 10.1136/ard.52.6.464. View

ROSE G . The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. Bull World Health Organ. 1962; 27:645-58. PMC: 2555832. View

Norton W, Nardo J . Vascular disease in progressive systemic sclerosis (scleroderma). Ann Intern Med. 1970; 73(2):317-24. DOI: 10.7326/0003-4819-73-2-317. View

Kallenberg C, Wouda A, The T . Systemic involvement and immunologic findings in patients presenting with Raynaud's phenomenon. Am J Med. 1980; 69(5):675-80. DOI: 10.1016/0002-9343(80)90417-9. View

Merino J, Casanueva B, Piney E, Val Bernal F, Rodriguez-Valverde V . Hemiplegia and peripheral gangrene secondary to large and medium size vessels involvement in C.R.E.S.T. syndrome. Clin Rheumatol. 1982; 1(4):295-9. DOI: 10.1007/BF02032090. View

Kahan A, Devaux J, Amor B, Menkes C, Weber S, Nitenberg A . Nifedipine and thallium-201 myocardial perfusion in progressive systemic sclerosis. N Engl J Med. 1986; 314(22):1397-402. DOI: 10.1056/NEJM198605293142201. View

Belch J, Zoma A, Richards I, McLaughlin K, Forbes C, Sturrock R . Vascular damage and factor-VIII-related antigen in the rheumatic diseases. Rheumatol Int. 1987; 7(3):107-11. DOI: 10.1007/BF00270462. View

Walmsley D, Goodfield M . Evidence for an abnormal peripherally mediated vascular response to temperature in Raynaud's phenomenon. Br J Rheumatol. 1990; 29(3):181-4. DOI: 10.1093/rheumatology/29.3.181. View

10.

Shapiro L . Large vessel arterial thrombosis in systemic sclerosis associated with antiphospholipid antibodies. J Rheumatol. 1990; 17(5):685-8. View

11.

Barile L, Bravo G, Pizarro S . Large vessel arterial thrombosis in systemic sclerosis with antiphospholipid antibodies. J Rheumatol. 1990; 17(12):1721-2. View

12.

Fowkes F, Housley E, Cawood E, Macintyre C, Ruckley C, Prescott R . Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol. 1991; 20(2):384-92. DOI: 10.1093/ije/20.2.384. View

13.

Belch J . Raynaud's phenomenon: its relevance to scleroderma. Ann Rheum Dis. 1991; 50 Suppl 4:839-45. PMC: 1033318. DOI: 10.1136/ard.50.suppl_4.839. View

14.

Wigley F, Wise R, Miller R, Needleman B, Spence R . Anticentromere antibody as a predictor of digital ischemic loss in patients with systemic sclerosis. Arthritis Rheum. 1992; 35(6):688-93. DOI: 10.1002/art.1780350614. View

15.

Goldhaber S, Manson J, Stampfer M, Lamotte F, Rosner B, Buring J . Low-dose aspirin and subsequent peripheral arterial surgery in the Physicians' Health Study. Lancet. 1992; 340(8812):143-5. DOI: 10.1016/0140-6736(92)93216-a. View

16.

Belch J, Veale D, Colleridge T . Large vessel disease in CREST. Ann Rheum Dis. 1993; 52(11):837-8. PMC: 1005203. DOI: 10.1136/ard.52.11.837-b. View