Macrovascular disease and systemic sclerosis

Objective-To determine if macrovascular disease is more prevalent in system ic sclerosis (SSc) compared with unaffected subjects. Methods-54 patients with SSc (both limited and diffuse disease) and 43 unaf fected control subjects of similar age and sex were recruited. All subjects underwent a basic screen for conventional atherosclerotic disease risk fac tors. All had non-invasive vascular assessments-that is, carotid duplex sca nning and measurement of ankle brachial blood pressure index-to identify th e presence of asymptomatic peripheral vascular disease. Results-33 of 52 (64%) patients had carotid artery disease compared with on ly 15 of 42 (35%) controls (p = 0.007). Eleven (21%) of these patients had moderate disease compared with only two (5%) controls (NS). Nine of 53 (17% ) SSc patients had evidence of peripheral arterial disease compared with no controls. This result was also statistically significant (p = 0.003). Ther e were no significant differences in the basic risk factor profile, which i ncluded cigarette smoking, systolic and diastolic blood pressure, cholester ol, trigyceride and glucose concentrations. Conclusion-Macrovascular disease is more common in SSc. Screening of these patients may allow identification of "at risk" patients at an early stage a nd allow the study of treatments to attenuate the high rate of cardiovascul ar mortality in these patients.