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BackgroundCardiovascular complications are a common cause of morbidity in inflammatory arthritis and connective tissue diseases like several studies have shown.ObjectivesDetection of cardiovascular risk factors and endothelial dysfunction in patients diagnosed with Systemic Sclerosis (SSc) and Mixed Connective Tissue Disease (MCTD). Creation of a longitudinal cohort of patients.MethodsStudies have been collected from April 2012 to December 2015. The data collection protocol included BMI, dyslipidemias, DM, HTN, previous or active smoking, thrombotic episodes, strokes and ischemic cardiopathy. ESR, CPR, cholesterol level, LDL, HDL, triglycerides, 25OH-D and homocysteine levels were requested to all patients. Vascular surgery's ultrasound protocol was: 1. Carotid study, intima-media thickness (IMT) and presence of plaques; 2. Ankel branquialindex (ABI), being pathological when ABI ≤0.9; 3. Endothelial dysfunction was assessed measuring abnormal brachial artery flow-mediated dilatation (FMD) after a four minutes transient ischemia period, being patologic if FMV <10% and severe if <5%.ResultsA total of 61 patients (95.1% women) were included: 28 SSc limited, 21 SSc diffuse, 2 SSc Sine Scleroderma, 4 MCTD, 3 overlap SSc-polymyositis and 3 Prescleroderma. The mean age at the time of the study and diagnosis were 49 (19–76) and 46 years (17–75). The average time of the disease was 5 years (0–37). 7 patients had HTN, 2 had DM, 18 hyperlipidemia (10 HCL, 2 HTG, 6 mixed hyperlipidemia), 9 active smokers, 18 ex-smokers, 2 patients with stroke, 2 have had thrombotic episodes and 1 had ischemic heart disease. The mean BMI was 24 (18–50) and 37.3% had a BMI>25.The mean value of the different analytic parameters was: ESR: 15 mm/h (1–55), PCR: 2.7 mg/L (0,1–22), COL: 198 mg/dL (143–298), 25OH D Vitamin:23,6 ng/mL (12–118), homocystein 10.8 micromol/l (5,9–19,5) and 21.4% had pathological levels ≥15 micromol/l. The mean modified Rodnan skin score was 9 (0–42), 20% of patients had ILD and 3 patients had PAH. 64% patients were treated with steroids, 65% DMARDs and 13.1% biologic therapies.The echographic findings were the following:1. The mean right and left common carotid IMT were 0.6 (0.47–1.2) and 0.7 mm (0.44–1.3) respectively. 66% and 61.2% of the cases had an increase of right and the left IMT respectively and 43% of both when it was compared with age group of reference population.2. 26% had unilateral plaques and 7% bilateral plaques.3. Three patients had a pathologic ABI.4. The average FMV was 4%, 80% cases had endothelial dysfunction, being severe in 51% of these.Conclusions1. Nearly 40% of patients have overweight (BMI>25).2. A high percentage of patients (16%) have hyperhomocyisteinemia.3. The percentage of subjects with increased IMT is high, around 65%. The presence of plaques is less frequent (30%).4. Endothelial dysfunction was found in 80% of the cases, and it was severe in almost 50%.ReferencesMan A et al. The risk of cardiovascular disease in systemic sclerosis. Ann Rheum Dis. 2013 Jul;72(7):1188- 93.Tyndall AJ et a...

BackgroundSeveral reports have shown the relationship between gout and increased cardiovascular risk (CVR). There is a lack of research in Spain about endothelial and cardiac dysfunction in goutObjectivesAnalyze CVR factors in gouty patients in our sample with vascular assessment, cardiological tests and laboratory parametersMethodsProspective cohort study with collection of clinical data, family history (FH) of gout and cardiovascular disease (CVD), and treatments received (calcium channel antagonists [CCA], ACE inhibitors [ACE-i], angiotensin receptor blokers [ARB], beta blockers [BB] or thiazides. A history of hypertension, diabetes (DM), dyslipidemia (DL), smoking, thrombotic events, ischemic heart disease (IHD) were also collected. Body mass index (BMI), serum uric acid (SUA), sedimentation rate (ESR), conventional/ultrasensitive RCP [cRCP, hsCRP], ferritin, total cholesterol (CHOL) and subtypes (HDLc, LDLc), triglycerides (TG), vitamin D and homocysteine were measured. Patients were referred to Vascular Surgery Department for ultrasound examination with search of carotid plaques and study of intima-media thickness (IMT), and also were to Cardiology Department for echocardiogram (ECHO-CG) and electrocardiogram (ECG)Results150 patients, 97% men and 3% women. Average age at time of study and diagnosis: 56 (23–92) and 47 years (15–79), respectively. Age at symptoms onset: 45 years (15–77). 22.5% had tophi and 11.3% urate stones. FH: 42% had gout history and 41% CVD history. Classical CVR factors: hypertension 47.3%; DM-2 4.6%, glucose intolerance 0.6%; DL 56.7% (CHOL: 37, TG: 15, both: 33); smokers 20.6% and quitters 37.6%, 21 pack/year (1–90); 1 patient had suffered stroke; 4 thrombosis; 17 IHD (11 angina, 6 myocardial infarction). 75% overweight/obesity, BMI 28 (19–40). Analytical parameters: ESR 10 mm/h (1–68), hs-CRP 2.7 mg/dL (0.1–57.7), c-CRP 2.3 mg/L (0–14.8); SUA 6.9 mg/dL (2.4–11.8); ferritin 259 ng/ml (11–2000); COL-t: 187 mg/dL (102–321, 6 not collected [NC]), HDLc 47 mg/dL (15–88; 22 NC), LDLc 113 mg/dL (15–248) TG 145 mg/dL (53–603); vitamin D 24.7 ng/mL (5.6–23.6; 28.6% <20); homocysteine 24.7 mmol/L (4–40; 32% >15 mmol/L). ECHO-CG: 6 valvular disease, 13 left ventricular hypertrophy, 45 had >1 finding, 5 NC. ECG was normal in 79 patients; 9 right bundle branch block (BBB), 1 left BBB, 4 IHD signs, 2 repolarization abnormalities and 6 arrhythmia; 13 had ≥2 findings, 9 showed other findings, 54 NC. Vascular examination: carotid IMT greater than corresponding adjusted by age group in 75% and 79% of patients (right and left, respectively); both: 65%. Carotid plaques 23%. Treatments: ACA 2.6%, ACE-i 2%, ARB 4.6%, BB 2%, thiazides 3.3%Conclusions75% of our patients have overweight/obesity. High percentage of subjects with hyperhomocysteinemia and/or vitamin D deficiency. Marked prevalence of increased IMT and carotid plaques, and outstanding number of cardiac abnormalities in ECHO-G/ECG. Further statistical studies will quantify the value of these early findings, that seem very relevantReferencesFeig DI...