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• W2580353758 abstract "OBJECTIVE: To evaluate endothelial dysfunction and microvascular damage in secondary Raynaud Phenomenon (SRP) and Systemic sclerosis (SSc)-associated patients as possible predictors of ischemic fingertip digital ulcers (DU) in a 3-year clinical follow-up. METHODS: Flow-mediated dilatation (FMD), na ilfold videocapillaroscopy (NVC), endothelin-1 (ET-1) and asymmetric dimethylarginine (ADMA) were analysed in a 3-year observational cohort study of 77 SRP patients with systemic sclerosis. The primary outcome was the occurrence of a new DU. RESULTS: Risk factors for DU at baseline were low FMD% (p < 0.001), NVC pattern (p < 0.001), high microangiopathy evolution score (MES) (p < 0.001), increased ET-1 (p < 0.001) and increased ADMA serum levels (p = 0.001). Median time to the occurrence of a new DU was 4.50 (1.25–16.25) months. The risk factors for the occurrence of at least one new DU episode in follow-up included a history of at least one DU before enrolment (p < 0.001), autoantibody anti-scleroderma-70 (p = 0.012), NVC late pattern (p < 0.001), high MES score (p < 0.001), low FMD% (p < 0.001) and increased ET-1 serum levels (p < 0.001). We used univariate Cox regression analysis to show that FMD >9.41% (HR: 0.37 95% CI: 0.14–0.99) and ET-1 >11.85 pmol/L (HR: 3.81 95% CI: 1.41–10.26) and NVC (HR: 2.29 95% CI: 0.97–5.38) were predictors of DU recurrence. In terms of first DU event in naïve DU patients at baseline, late NVC pattern (HR: 12.66 95% CI: 2.06–77.89) and MES score (HR: 1.693 95% CI: 1.257–2.279) were independent predictors. CONCLUSION: This study identified endothelium dysfunction biomarkers (FMD and ET-1) and severe microvascular damage in NVC as strong predictors of new DU in SSc patients." @default.
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• W2580353758 date "2017-06-10" @default.
• W2580353758 modified "2023-10-01" @default.
• W2580353758 title "Endothelial dysfunction, microvascular damage and ischemic peripheral vasculopathy in systemic sclerosis" @default.
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• W2580353758 doi "https://doi.org/10.3233/ch-150044" @default.
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