Atherosclerosis in thrombotic primary antiphospholipid syndrome

Background: Primary antiphospholipid syndrome (PAPS) is characterized by arterial and venous thrombosis, pregnancy loss, often recurrent, in the presence and persistence on antiphospholipid antibodies (aPL). The issue of early atherosclerosis, as evaluated by measuring carotid intima media thickness (IMT), associated with aPL, has been limitedly explored in PAPS. Methods: In an age- and sex-matched case-double-control study, intima media thickeness of carotid arteries was measured using high-resolution B-mode ultrasound in 49 thrombotic PAPS patients (18 M, 31 F, mean age 37 +/- 11), in 49 patients who suffered thrombosis for inherited thrombophilia and 49 healthy subjects. Results: Average carotid IMT was always greater in PAPS than control patients (common carotid P = 0.004, bifurcation P = 0.013, internal carotid P = 0.001). By dividing participants into age tertiles most of the difference was explained by greater IMT of PAPS patients in the second (common carotid P = 0.003, bifurcation P = 0.023, internal carotid P = 0.003) and third tertiles (common carotid P = 0.03, bifurcation P = 0.004, internal carotid P = 0.007). Conclusions: Premature atherosclerosis is a clinical feature of our thrombotic PAPS patients.