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Abstract Number: 2993

Vascular Involvement in Behcet’s Syndrome May be Associated with Subclinical Atherosclerosis

Emine USLU YURTERI1, EVREN ÜSTÜNER2, Murat TORGUTALP1, Mucteba Enes YAYLA1, Ilyas Ercan OKATAN1, Ayse Bahar KELESOGLU DINCER1, Serdar SEZER1, Emine Gozde AYDEMIR GULOKSUZ1, Tahsin Murat TURGAY1, Gülay KINIKLI3 and Aşkın Ateş4, 1Department of Internal Medicine, Division of Rheumatology, Ankara University School of Medicine Department of Internal Medicine, Division of Rheumatology, ANKARA, Turkey, 2RADIOLOGY, ANKARA UNIVERSITY RADIOLOGY DEPARTMENT, ANKARA, Turkey, 3Department of Internal Medicine, Division of Rheumatology, Ankara University School of Medicine Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey, 4Department of Internal Medicine, Division of Rheumatology, Ankara University School of Medicine, Ankara, Turkey

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: atherosclerosis and vasculitis, Behcet's syndrome

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Session Information

Date: Wednesday, October 24, 2018

Title: 6W025 ACR Abstract: Vasculitis–Non-ANCA-Assocd & Rel D/Os III: Clinical Subtype & Outcome(2988–2993)

Session Type: ACR Concurrent Abstract Session

Session Time: 11:00AM-12:30PM

Background/Purpose: Behçet’s Syndrome (BS) is a vasculitic process which is characterized by recurrent oral and genital aphthous ulcerations, ocular, vascular, neurological, and gastrointestinal involvement . Although the exact pathogenic mechanism for vascular lesions in BS patients is still unclear, endothelial dysfunction may be important in the development of these lesions . Endothelial dysfunction is accepted as the initial lesion in atherogenesis and recent studies have shown that the increase in carotid intima media thickness (cIMT) is significantly associated with endothelial dysfunction. In this study, it was aimed to determine the frequency of subclinical atherosclerosis (ATS) according to vascular involvement in BS patients.

Methods:  A hundred patients with BS and 30 healthy controls (HC) were included in this study. Participants with a history of cardiovascular (CV) events, type 1 or 2 diabetes mellitus, chronic kidney disease, and malignancy were excluded. Bilateral cIMTs were evaluated by using B-mode ultrasonography (US) in BS patients and compared with those in controls. Subclinical atherosclerosis was defined by CIMT≥0.9 mm or ≥1 carotid plaque which accepted as US positive group.

Results: The demographic characteristics, cardiovascular risk factors and US findings of patients with BS and HC are listed in table 1. cIMT in BS patients was higher compared to HC (0.78±0.21 mm versus 0.69±0.13 mm; p=0.006). Thirty two (32%) BS patients, and two (6,7%) HC had subclinical atherosclerosis (BS versus HC: p=0.006).cIMT in BS patients with vascular involvement was higher  than nonvascular group (0.83±0.21 versus 0.75±0.21; p=0.072). Comparison of disease characteristics and traditional CV risk factors of US positive and US negative BS patients are shown in Table 2. In regression analysis, older age and having vascular disease were independently associated with subclinical ATS (Table 3).

Conclusion: This study showed that cIMT measurements were higher in BS patients than HC and also significantly higher in BS patients with vascular group than nonvascular group. Vascular involvement in BS patients is an independent risk factor for the development of ATS. Therefore, BS patients with vascular involvement should be carefully monitored for the development of CV disease.

Table 1. The demographic characteristics, CV risk factors, and carotid US findings of patients with Behçet’s syndrome and healthy controls

BS

(n=100)

HC

(n=30)

p value

Age, years

45.9 ± 12.0

41.8 ± 12.2

0.097

Female, n. (%)

62 (62)

18 (60)

0.834

Hypertension, n. (%)

17 (17)

7 (23.3)

0.433

Ever smoked, n. (%)

42 (42)

10 (33.3)

0.395

ESR, mm/hour

14.45 ± 12.74

10.93 ± 7.33

0.152

CRP, mg/liter

7.03 ± 14.39

3.40 ± 4.63

0.031

LDL cholesterol*, mg/dl

120.7 ± 34.1

116.0 ± 22.6

0.433

Low HDL cholesterol*, n. (%)

39 (52.7)

11 (47.8)

0.683

Total cholesterol*, mg/dl

195.4 ± 42.1

184.9 ± 23.8

0.137

Total cholesterol/HDL cholesterol*

4.29 ± 1.02

3.97 ± 0.88

0.176

Triglicerides >150 mg/dl*, n. (%)

25 (33.8)

4 (16)

0.091

Right  CIMT

0.79 ± 0.25

0.70 ± 0.14

0.011

Left CIMT

0.77 ± 0.21

0.68 ± 0.14

0.029

Mean  CIMT

0.78 ± 0.21

0.69 ± 0.13

0.006

CIMT ≥ 0.90 mm, no. (%)

29 (29)

1 (3.3)

0.003

CIMT ≥ 0.90 mm and/or carotid plaque, n. (%)

32 (32)

2 (6.7)

0.006

Carotis plaques, no. (%)

8 (8)

1 (3.3)

0.684

*Lipid profile was available for 99 patients

Table 2. Characteristics of US positive and US negative BS patients

US positive       

(n=32)

US negative

(n=68)

p value

Age, years

53.2 ± 9.6

42.5 ± 11.5

< 0.001

Female, no. (%)

18 (56.3)

44 (64.7)

0.416

Disease duration, years

14.9 ± 10.9

12.9 ± 9.5

0.367

BSAS

14.8 ± 9.8

14.3 ± 9.2

0.792

Vascular Behçet disease, no. (%)

15 (46.9)

18 (26.5)

0.043

Posterior uveitis and retinal vasculitis ever,no. (%)

6 (18.8)

13 (19.1)

0.965

Major organ involvement, no. (%)

20 (62.5)

28 (41.2)

0.046

Glucocorticoid usage ever, no. (%)

10 (34.5)

28 (39.4)

0.643

Immunosuppresive theraphy, no. (%)

14 (43.8)

25 (36.8)

0.504

Hypertension, no. (%)

8 (25)

9 (13.2)

0.144

Ever smoked, no. (%)

10 (31.3)

32 (47.1)

0.135

ESR, mm/hour

17.6 ± 18.2

13.0 ± 8.9

0.177

CRP, mg/liter

7.27 ± 12.84

6.92 ± 15.15

0.912

LDL cholesterol*, mg/dl

121.2 ± 34.8

120.5 ± 34.1

0.934

Low HDL cholesterol*, no. (%)

15 (57.7)

24 (50)

0.527

Total cholesterol*, mg/dl

196.8 ± 36.7

194.7 ± 43.7

0.836

Total cholesterol/HDL cholesterol*

4.5 ± 1.0

4.2 ±1.0

0.174

Triglicerides >150 mg/dl*, no. (%)

10 (38.5)

15 (31.3)

0.531

*Lipid profile was available for 99 patients

Table 3. Multiple logistic regression analysis for the co–factors that affect subclinical atherosclerosis

Univariate

Multivariate

p

OR

95% CI

B

SE

p

OR

95 % CI

Hypertension

0.150

2.185

0.754-6.333

Triglyceride

0.057

1.008

1.000-1.016

Total cholesterol/HDL

0.174

1.405

0.860-2.295

Major organ involvement

0.014

3.367

1.285-8.827

ESR

0.107

1.028

0.994-1.063

0.032

0.019

0.100

2.708

0.994-1.072

Age

< 0.001

1.096

1.045-1.149

0.096

0.030

0.001

1.101

1.038-1.167

Vascular Behçet disease

0.046

2.451

1.018-5.902

1.125

0.610

0.040

3.491

1.056-11.537


Disclosure: E. USLU YURTERI, None; E. ÜSTÜNER, None; M. TORGUTALP, None; M. E. YAYLA, None; I. E. OKATAN, None; A. B. KELESOGLU DINCER, None; S. SEZER, None; E. G. AYDEMIR GULOKSUZ, None; T. M. TURGAY, None; G. KINIKLI, None; A. Ateş, None.

To cite this abstract in AMA style:

USLU YURTERI E, ÜSTÜNER E, TORGUTALP M, YAYLA ME, OKATAN IE, KELESOGLU DINCER AB, SEZER S, AYDEMIR GULOKSUZ EG, TURGAY TM, KINIKLI G, Ateş A. Vascular Involvement in Behcet’s Syndrome May be Associated with Subclinical Atherosclerosis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/vascular-involvement-in-behcets-syndrome-may-be-associated-with-subclinical-atherosclerosis/. Accessed .
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