Ulnar Artery Occlusion and severity markers of vasculopathy in Systemic sclerosis a multicenter cross-sectional study

Abstract : OBJECTIVE:to evaluate the association of ulnar artery occlusion (UAO) assessed by Doppler Ultrasonography (dUS) with the severity markers of systemic sclerosis (SSc) METHODS: 204 unselected patients fulfilling 2013 ACR/EULAR classification criteria for SSc were included in this cross-sectional multicenter study. All patients benefit from bilateral hand dUS evaluating the presence of UAO and clinical/paraclinical visceral evaluation according to current guidelines. Univariable and multivariable ordinal regression models were conducted, grading the severity of UAO as "no UAO", "only one UAO" and "UAO on both hands" and assessing its association with clinical features of SSc.RESULTS:UAO was found in 76 patients (37.3%) and was bilateral in 49 (24.0%). UAO as an ordinal event was significantly associated with disease duration, history of fingertip ulcers, telangiectasia, higher Rodnan skin score, worse DLCO values, higher tricuspid jet velocity, late capillaroscopic pattern and positivity for anti-centromere antibodies (ACA) (univariable analysis). In the adjusted multivariable ordinal model, UAO was less frequent in women (OR=0.35 [0.15-0.83]; p=0.017) and in patients with steroids (OR=0.24 [0.09-0.62]; p=0.0034). Significant association with UAO was persistent in multivariable analyses for history of fingertip ulcers (OR=2.55 [1.24-5.21]; p=0.011), higher Rodnan skin score (OR=1.65 [1.06-2.56]; p=0.025), lower DLCO values (OR=0.85 [0.78-0.94]; p=0.0015) and positivity of ACA (OR=2.89 [1.36-6.11]; p=0.0056).CONCLUSION:UAO may represent a relevant severity marker of the vasculopathy in SSc. Its predictive value for the onset of severe vascular manifestations such as pulmonary arterial hypertension and its association with mortality remain to be determined in longitudinal studies.
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Eric Hachulla, Patrick Jego, Alain Lescoat, Cécile Marie Yelnik, Guillaume Coiffier, et al.. Ulnar Artery Occlusion and severity markers of vasculopathy in Systemic sclerosis a multicenter cross-sectional study. Arthritis & rheumatology, Wiley, 2018, 71 (6), pp.983-990. ⟨10.1002/art.40799⟩. ⟨hal-01976468⟩

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