{
  "abstract": "Introduction Systemic sclerosis (SSc) is a connective tissue disease characterized by fibrosis and vasculopathy. While microvascular damage is well recognized, macrovascular disease such as peripheral arterial disease (PAD) has been less studied. PAD, a major atherosclerotic complication, increases cardiovascular risk. This case-control study evaluated PAD prevalence in SSc and its clinical associations.Material and Methods We performed a cross-sectional case-control study in a tertiary center including patients fulfilling ACR/EULAR 2013 or VEDOSS criteria registered in Reuma.pt. A control group was recruited. Sociodemographic and clinical data were collected. PAD was defined as an ankle-brachial index (ABI) <0.9. Statistical analysis used x2 or Fisher’s exact tests and logistic regression for significant associations.Results Eighty-eight SSc patients and 60 controls were included. Patients were predominantly female (85.2% vs. 43.3%, p<0.001) and reported less alcohol use (13.6% vs. 55.0%, p<0.001). PAD prevalence was higher in SSc (10.2% vs. 1.6%, p=0.048). No between-group differences were found for hypertension, diabetes, dyslipidemia, or smoking.Among SSc patients, 92.0% met ACR/EULAR criteria and 75.0% had limited cutaneous disease. PAD patients were older (66.2±12.2 vs. 59.3±12.3), more frequently male (33.3% vs. 12.7%), and had higher frequencies of digital ulcers (66.7% vs. 20.3%, p=0.019), hypertension (55.6% vs. 17.7%, p=0.021), and calcinosis (77.8% vs. 10.1%, p<0.001). No associations emerged with antibody profile, disease subtype, or other cardiovascular risk factors. Multivariate analysis identified calcinosis (OR=37.9, 95%CI 4.6–308.9, p<0.001) and hypertension (OR=8.8, 95%CI 1.1–68.5, p=0.038) as independent PAD predictors. Digital ulcers showed a borderline association (OR=7.1, 95%CI 1.0–52.2, p=0.055). In the full cohort model (SSc+controls), SSc remained an independent PAD predictor (OR=22.9, 95%CI 2.0–258.2, p=0.011), after adjusting for sex, alcohol, and hypertension.Conclusions Our findings show that PAD is more common in SSc than in the general population, highlighting macrovascular disease as an underrecognized complication. Its strong association with calcinosis, hypertension, and possibly digital ulcers suggests PAD may mark a more severe disease phenotype and poorer outcomes. Considering that vascular calcification is a known predictor of PAD and adverse prognosis, the link with calcinosis may reflect shared mechanisms of vascular injury and calcification, placing these patients in a higher cardiovascular risk category. Stricter risk control, lifestyle measures, and possibly early statin therapy could be beneficial. ABI screening may provide a simple tool for risk stratification, but further studies are needed to confirm these associations and assess whether targeted cardiovascular management improves outcomes in SSc.Abstract P.391 Table 1Comparison of sociodemographic characteristics, traditional cardiovascular risk factors and doppler data in patients with systemic sclerosis (n=88) and controls (n=60)Abstract P.391 Table 2Association of systemic sclerosis features with peripheral arter lal disease (ABI<0.9) in patients with systemic sclerosis (n =B5)",
  "authors": [
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Carlos Gomes"
    },
    {
      "affiliations": [
        "Angiology and Vascular Surgery Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Diogo Domingues"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Mariana Diz-Lopes"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Bárbara Esteves"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Sara Lopes"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Ana Sá"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de Viseu, Viseu, Portugal"
      ],
      "name": "Marina Oliveira"
    },
    {
      "affiliations": [
        "Rheumatology Department, Hospital Divino Espírito Santo, Ponta Delgada, Portugal"
      ],
      "name": "Mariana Sebastião"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Miguel Natal"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Miguel Bernardes"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Raquel Ferreira"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Georgina Terroso"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Lúcia Costa"
    },
    {
      "affiliations": [
        "Angiology and Vascular Surgery Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Joana Ferreira"
    },
    {
      "affiliations": [
        "Angiology and Vascular Surgery Department, Unidade Local de Saúde de São João, Porto, Portugal"
      ],
      "name": "Armando Mansilha"
    }
  ],
  "title": "P.391 Exploring the link: systemic sclerosis and peripheral arterial disease – data from a tertiary centersystemic sclerosis (SSc) is a connective tissue disease characterized by fibrosis and vasculopathy",
  "uid": "05f5d49b-2e2c-5540-9f21-62e283e8ac4e"
}