Review Article

Cardiovascular Involvement in Autoimmune Diseases

Table 5

Traditional and nontraditional risk factors associated with CVD and SSc.

Risk factorCommentsReferences

Traditional risk factors
Dyslipidemia(i) The alteration of lipid profile has been described, given by the increased levels of LDL and lipoprotein A, which are related to the reduction in the fibrinolysis and thrombotic and coronary events.  
(ii) Decreased levels of HDL are related to anticentromere antibodies positivity.  
(iii) There is elevation of TAG, total cholesterol, and LDL and decrease in HDL levels.
[214, 218, 421424]
T2DMIt is associated with CV events in SSc patients.  [54, 424]
HypertensionIts prevalence increased with the age, and it is correlated with MI.  [54]
HyperhomocysteinemiaIncreased levels are related to AT and endothelial dysfunction.  [218]

Nontraditional risk factors
SSc per seIt is an independent risk factor for MI [54]
Autoantibodies (i) oxLDL/2GPI and anti-oxLDL/2GPI complex: these are considered proatherogenic.  
(ii) anti-ox-LDL: higher levels are correlated with AT and thrombosis.  
(iii) anti-LPL: its presence is related to TAG elevated and AT and CV events.  
(iv) AECA may also contribute to an increased risk of early AT in SSc 
(v) Others: anticentromere, anti-HSP65/60, and APLA.  
[91, 220, 423, 425429]
Chronic inflammationIncrease of CRP levels and intercellular adhesion molecule-1 may also contribute to an increased risk of early AT in SSc.[218, 429]

AECA: anti-endothelial cell antibodies; anti-HSP: anti-heat shock proteins antibodies; anti-LPL: anti-lipoprotein lipase antibodies; an anti-oxLDL/2GPI complex: anti-oxidized low-density lipoprotein/2 glycoprotein I antibodies; APLA: antiphospholipid antibodies; AT: atherosclerosis; CRP: c-reactive protein; CV: cardiovascular; CVD: cardiovascular disease; HDL: high-density lipoprotein cholesterol; LDL: low-density lipoprotein; oxLDL/2GPI complex: oxidized low-density lipoprotein/2 glycoprotein I; SSc: systemic sclerosis; TAG: triglycerides; T2DM: type 2 diabetes mellitus.