Prolonged Exposure to Antiphospholipid Antibodies Is Associated with Endothelial Dysfunction in Patients with Systemic Lupus Erythematosus

In-Woon Baek¹, Yune-Jung Park², Ki-Jo Kim³, Wan-Uk Kim Sr.⁴ and Chul-Soo Cho¹, ¹Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea, Republic of (South), ²Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Gyeonggido, Korea, Republic of (South), ³Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea, Republic of (South), ⁴The Catholic University of Korea, Department of Internal Medicine, seoul, Korea, Republic of (South)

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: SLE and antiphospholipid antibodies

Session Information

Date: Sunday, November 5, 2017

Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster I: Biomarkers and Outcomes

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Antiphospholipid syndrome has been shown to be associated with increased cardiovascular mortality, but the role of antiphospholipid antibodies (aPL) on endothelial dysfunction remains elusive. We investigated the association between endothelial dysfunction and aPL in systemic lupus erythematosus (SLE) patients.

Methods: 185 SLE patients and 62 controls were enrolled. Endothelial function was measured by flow-mediated dilatation (FMD). Cardiovascular risk factors were assessed and quarterly measurement of anti-cardiolipin (aCL) and anti-b₂glycoprotein I Ab were used to calculate time-integrated values throughout disease duration. Circulating endothelial progenitor cell (EPC), defined by CD34+/KDR+ mononuclear cells, was quantified by flow cytometry.

Results: Median FMD was significantly lower in SLE patient than in controls (6.9 versus 9.3%, P<0.001). In univariate analysis, older age, hypertension, and persistent positive lupus anticoagulant (LAC) were associated with decreased FMD in SLE patients (P=0.034, P=0.020, and P=0.028). Time-integrated aCL value (TI-aCL), but not a single value, was correlated with decreased FMD (P=0.003). Multivariate analysis showed that hypertension and TI-aCL were independent factors for decreased FMD (P=0.012, P=0.011); addition of positive LAC increased the adjusted probability of decreased FMD (P=0.003). FMD was correlated with EPC number (r=0.342, P=0.005) and TI-aCL was also an independent factor of reduced EPC after multiple adjustment (P=0.024). The predicted probability of endothelial dysfunction at median EPC level was higher in group with high TI-aCL than in group with low TI-aCL (P=0.004).

Conclusion: Cumulative burden of aPL was closely associated with endothelial dysfunction in SLE patients, which was mediated in part by reduction of EPC.

Disclosure: I. W. Baek, None; Y. J. Park, None; K. J. Kim, None; W. U. Kim Sr., the National Research Foundation of Korea, 2; C. S. Cho, None.

To cite this abstract in AMA style:

Baek IW, Park YJ, Kim KJ, Kim WU Sr., Cho CS. Prolonged Exposure to Antiphospholipid Antibodies Is Associated with Endothelial Dysfunction in Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/prolonged-exposure-to-antiphospholipid-antibodies-is-associated-with-endothelial-dysfunction-in-patients-with-systemic-lupus-erythematosus/. Accessed .

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/prolonged-exposure-to-antiphospholipid-antibodies-is-associated-with-endothelial-dysfunction-in-patients-with-systemic-lupus-erythematosus/