Background/Purpose:

Low Ankle-brachial index (ABPI) < 0.9 demonstrating peripheral vascular disease (PVD), is a marker of subclinical cardiovascular disease and it is an inexpensive and easy method in which to assess peripheral vascular disease (PVD). Cardiovascular morbidity in systemic lupus erythematosus (SLE) is at least as frequent as in age- and sex-matched type-1 diabetes mellitus patients, making SLE a cardiovascular disease equivalent. Therefore, aggressive screening and management of cardiovascular risk factors should be performed to reduce this risk and improve long term mortality from vascular events.

Methods:

The present study evaluated prevalence and risk factors for peripheral vascular disease in patients with SLE in a sub-Saharan country, Ghana. Secondly, it examined the correlates with disease characteristics, activity indices and traditional risk factors of atherosclerosis.

A prospective cohort of 77 Ghanaian female patients with SLE had clinical, laboratory parameters, disease activity, damage indices, treatment and traditional risk factors for atherosclerosis evaluated between those with and without PVD measured using ankle brachial pressure index (ABPI).

Results:

The prevalence of PVD was 22.73% with a mean age of 30.94 (SD ± 8.22) years (range: 20 – 60 years). Women with normal ABPI were older than those with abnormal ABPI, but this was not statistically significant (31.5 verses 28.5 years, p = 0.192).

From the multiple logistic regression model, prednisolone dosage, waist to height ratio (WHR), low density lipoprotein(LDL) as well as educational level were the statistically significant factors associated with higher prevalence of PVD (p<0.05). A unit increase in WHR decreased the odds of developing PVD by 0.0013 (95% CI: 0.00 – 0.18). Increase in prednisolone dosage increases the patient’s odds of developing PVD by 0.88(95% CI: 0.79 – 0.99). Each one unit rise in patient’s LDL increased their odds of getting PVD by 0.52(95% CI : 0.27 – 0.98). Patients odds of being diagnosed with PVD increased by 0.85(95% CI: 0.76 – 0.96) for each year after diagnosis. Higher educational level was associated with lower odds of developing PVD. Patients with tertiary education had 99% (AOR: 0.01, 95% CI: 0.00 – 0.47) lower odds of developing PVD.

Conclusion:

There is an increase prevalence of PAD in this Ghanaian cohort of SLE patients compared to the general public but lower than other SLE cohorts, despite being younger than other SLE cohorts and female. Traditional cardiovascular factors as well as disease related factors like disease duration and prednisolone use are associated. Follow up studies would see the impact of this on disease outcome and organ damage, especially on their neurocognitive effect which has not been studied previously.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-and-predictors-of-peripheral-vascular-disease-in-a-cohort-of-systemic-lupus-erythematosus-sle-patients/