Abstract

ABSTRACT:
BACKGROUND:
Accelerated atherosclerosis is a well-recognized complication of systemic lupus erythematosus (SLE). Its etiology is a multifactorial and several methods may be used to detect the presence and severity of peripheral arterial disease (PAD).
OBJECTIVE:
To assess ankle brachial index (ABI) in Iraqi patients with SLE, and to evaluate predictors of this relationship.
PATIENTS AND METHODS:
Forty three Iraqi SLE patients and 50 healthy controls were included in this study. Full history was taken and complete clinical examination was done for all individuals in both groups. Disease characteristics [age, sex, body mass index (BMI), duration of disease, SLE disease activity index (SLEDAI), smoking history, family history, hypertension, hyperlipidemia, thrombosis, Raynaud’s phenomenon and drugs used] were also documented. Laboratory analysis included complete blood count, general urine examination, serum lipid profile, fasting blood sugar, thyroid function tests, anti-double stranded deoxyribonucleic acid (anti-ds-DNA), complements components and anti-phospholipid anti-bodies. Individuals in both groups were assessed using the ABI. The ABI was measured using a contour wrapped 12cm cuff attached to a mercury sphygmomanometer and 5-10 MHz Doppler in the arms and legs; a ratio of ≤0.9 was considered abnormal. Abnormal ABI was categorized as mild, moderate and severe.
RESULTS:
Seven (16%) Iraqi SLE patients have abnormal ABI compared with 0% of controls (P=0.010). All patients were of mild abnormal ABI(P=0.003).There was significant association between abnormal ABI and: sex, smoking history, and cyclophosphamide therapy (P=0.000, P=0.001, P= 0.020 respectively) but there was no significant association between abnormal ABI; and other patients’ characteristics[ age, BMI, duration of disease, SLEDAI, family history, hypertension, thrombosis, Raynaud’s phenomenon, or drugs used (steroid, mycophenolate mofetil, hydroxychloquin, non-steriodal anti-inflammatory drugs and statins)] (P=0.579, P=0.754, P=0.823, p=0.148, P=0.655, P=0.233, P=0.655, P=0.241, P=0.512, P=0.335, P=0.315, P=0.655 , P=0.185) respectively.
CONCLUSION:
Mild abnormal ABI occurs with high frequency (16%) in Iraqi SLE patients. Males, smoking history, and cyclophosphamide therapy are significant predictors