Can cardiovascular risk factors affect the result of nailfold videocapillaroscopy? A retrospective multicentre study

Abstract

Objectives

Nailfold capillaroscopy (NC) is used in the study of Raynaud’s phenomenon (RPh). Many people have cardiovascular risk factors (CVRF): tobacco (TOB), diabetes (DM), alcohol (ALC), dyslipidaemia (DL), arterial hypertension (HT), and obesity (OBE). The objective of the work was to investigate whether CVRF produce capillaroscopic alterations, which could influence their final interpretation.

Methods

Multicentre descriptive retrospective study of patients referred to CP consultation for RPh or suspected connective tissue disease in two Madrid hospitals between 2015 and 2018. 200x videocapillaroscopy (Dinolite®) was used. Analytical, clinical, therapeutic variables, CVRF, and capillaroscopic alterations (tortuosities, ramifications, dilations, giant capillaries, decreased density, and haemorrhages) were collected. For the statistical study, parametric and non-parametric tests were used (statistical significance at p < .05).

Results

340 medical records were reviewed, 286 (84.1%), mean age of 52.36±16.97 years; 270 had RPh (79.4%) and 212 (62.4%) CVRF: 108 TOB (31.8%), 108 DL (31.8%), 62 H T (18.2%), 20 DM (5.8%), 8 ALC (2.4%). Three groups were formed: 155 primary RPh (45.6%), 123 with connective tissue disease (36.2%) and 62 with other osteoarticular diseases (18.2%). The statistical study showed an association between all capillaroscopic alterations and CVRF (p < .001), as well as between: decreased density with HT (p = 0.006); tortuosities with HT (p < .001) and hypercholesterolaemia (p = .006); Dilations, ramifications, haemorrhages with HT (p < .001, p = .019, and p = .008) and TOB (p < .001, p = .019, and p = .002); giant capillaries with TOB (p = .034).

Conclusions

This work shows the association between capillaroscopic alterations and CVRF, which should be considered for correct CP interpretation.