Resumo Contexto O pré-diabetes (PD) é definido como glicemia de jejum alterada e/ou tolerância à glicose alterada (TGA) e pode estar associado a alto risco de lesão cardiovascular. Recomenda-se discriminar quais pacientes com PD podem apresentar sinais de rigidez arterial e lesão cardiovascular para reforçar as estratégias terapêuticas. Objetivos Identificar os valores discriminativos da velocidade de onda de pulso determinantes de rigidez arterial e lesão cardiovascular em pacientes com PD. Métodos Estudo transversal em pacientes com PD (N=43) e normoglicêmicos (N=37) submetidos a avaliação clínica, avaliação da rigidez arterial pela velocidade da onda de pulso carótido-femoral (cfPWV) utilizando SphygmoCor, análise laboratorial de sangue, investigação de alterações morfológicas e variáveis cardíacas funcionais por ecocardiograma transtorácico e avaliação da espessura íntima-média carotídea (EIMC) pela ultrassonografia da carótida. A análise estatística foi realizada no software SPSS, e valores de p<0,05 foram considerados significativos. Resultados Foi identificado um valor de corte cfPWV de 6,9 m/s para TGA (sensibilidade 74% e especificidade 51%). A comparação dos dados e fatores de risco entre valores acima e abaixo do valor de corte estabelecido revelou glicemia de jejum elevada (p=0,02), obesidade (p=0,03), dislipidemia (p=0,004), sinais precoces de função diastólica prejudicada do ventrículo esquerdo (p=0,017) e ventrículo direito (p=0,03) e maior EIMC em cfPWV ≥6,9m/s (p=0,04). Conclusões Em pacientes com PD, o cfPWV de 6,9 m/s foi considerado um valor discriminativo de rigidez arterial. Esses achados reforçam que a investigação precoce da lesão cardiovascular e uma estratégia com terapia agressiva são valiosas no controle dos fatores de risco na PD. prédiabetes pré diabetes (PD eou ou (TGA Recomendase Recomenda se terapêuticas N=43 N43 N 43 (N=43 N=37 N37 37 (N=37 clínica carótidofemoral carótido femoral (cfPWV SphygmoCor sangue íntimamédia íntima média (EIMC carótida SPSS p005 p 0 05 p<0,0 significativos 69 6 9 6, ms m s sensibilidade 74 51%. 51 51% . 51%) p=0,02, p002 p=0,02 , 02 (p=0,02) p=0,03, p003 p=0,03 03 p=0,004, p0004 p=0,004 004 (p=0,004) p=0,017 p0017 017 (p=0,017 (p=0,03 69ms 9m p=0,04. p004 p=0,04 04 (p=0,04) N=4 N4 4 (N=4 N=3 N3 3 (N=3 p00 p<0, 7 5 p=0,0 (p=0,02 p000 p=0,00 00 (p=0,004 p=0,01 p001 01 (p=0,01 (p=0,0 (p=0,04 N= (N= p0 p<0 p=0, (p=0,00 (p=0, (N p< p=0 (p=0 p= (p= (p

Abstract Background Prediabetes (PD) is defined as impaired fasting glucose and/or impaired glucose tolerance (IGT) and may be associated with high risk of cardiovascular injury. It is recommended that PD patients be screened for signs of arterial stiffness and cardiovascular injury to reinforce therapeutic strategies. Objectives To identify pulse wave velocity values discriminative for arterial stiffness and cardiovascular injury in PD patients. Methods A cross-sectional study was conducted with PD (N=43) and normoglycemic (N=37) patients who underwent clinical evaluation, arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor, laboratory blood analysis, investigation of morphological and functional cardiac variables by transthoracic echocardiogram, and assessment of carotid intima-media-thickness (CIMT) by carotid ultrasonography. A statistical analysis was performed using SPSS software and values of p<0.05 were considered significant. Results A cfPWV cut-off value of 6.9 m/s was identified for IGT (Sensitivity [SE]: 74% and Specificity [SP]: 51%). Comparison of general data and risk factors between subsets with values above and below this cutoff value revealed higher rates of fasting glucose (p=0.02), obesity (p=0.03), dyslipidemia (p=0.004), early signs of left ventricle (p=0.017) and right ventricle (p=0.03) impaired diastolic function, and elevated CIMT in subjects with cfPWV ≥ 6.9m/s (p=0.04). Conclusions In PD patients, a cfPWV cutoff of 6.9 m/s was considered a discriminative value for arterial stiffness. These findings highlight the value of early investigation of cardiovascular injury and aggressive therapy strategies with good control of risk factors in PD. (PD andor or (IGT crosssectional cross sectional N=43 N43 N 43 (N=43 N=37 N37 37 (N=37 evaluation carotidfemoral femoral (cfPWV SphygmoCor echocardiogram intimamediathickness intima media thickness (CIMT ultrasonography p005 p 0 05 p<0.0 significant cut off 69 6 9 6. ms m s Sensitivity SE [SE] 74 SP [SP] 51%. 51 51% . 51%) p=0.02, p002 p=0.02 , 02 (p=0.02) p=0.03, p003 p=0.03 03 p=0.004, p0004 p=0.004 004 (p=0.004) p=0.017 p0017 017 (p=0.017 (p=0.03 function 69ms 9m p=0.04. p004 p=0.04 04 (p=0.04) N=4 N4 4 (N=4 N=3 N3 3 (N=3 p00 p<0. [SE 7 [SP 5 p=0.0 (p=0.02 p000 p=0.00 00 (p=0.004 p=0.01 p001 01 (p=0.01 (p=0.0 (p=0.04 N= (N= p0 p<0 p=0. (p=0.00 (p=0. (N p< p=0 (p=0 p= (p= (p

Abstract Background Systemic Sclerosis (SSc) patients may need hand surgery. Objective To develop a screening tool for rheumatologists to identify potential candidates with systemic sclerosis for hand surgery, optimizing referrals. Methods A pilot cross-sectional study from January 2015 to December 2016. Sample size: 51 participants. Inclusion criteria: ≥ 18 years old, meeting the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for SSc and hand impairment. Data collected: age, sex, race, disease duration, SSc subtypes, vasodilator use, skin thickness, finger stiffness, presence of Digital Ulcers (DU) and/or calcinosis, presence of Raynaud's Phenomenon (RP) attacks, health status and disability, disease status, pain intensity and functional status of the hands. Data were analyzed by a multivariate logistic regression model. Results Fulfillment of surgical criteria: 68.8%. The surgical group had higher scores on the HAQ-DI (1.39 vs. 0.96, p =0.032) and CHFS (25.0 vs. 12.0, p =0.005) questionnaires, and a higher frequency of DU (91.43% vs. 18.75%, p <0.0010), calcinosis (60.0% vs. 0.0%, p <0.001), use of vasodilators (100.0% vs. 75.0%, p =0.007) and digital stiffness (28.57% vs. 0.0%, p =0.017). The presence of DU increased the chance of surgical indication by 46.2 times (ORIC 95% = 8.23 to 259.49). The statistical model showed good accuracy (86.3%, p <0.001), sensitivity (91.4%), and specificity (81.2%). Conclusion The presence of DU in SSc could be used as a screening feature for early identification and referral of potential candidates for hand surgery. (SSc surgery referrals crosssectional cross sectional 201 2016 size 5 participants 1 old RheumatologyEuropean Rheumatology European ACR/EULAR ACREULAR ACR EULAR (ACR/EULAR impairment collected age sex race duration subtypes thickness (DU andor or Raynauds Raynaud s RP (RP attacks disability hands 688 68 8 68.8% HAQDI HAQ DI 1.39 139 39 (1.3 vs 096 0 96 0.96 =0.032 0032 032 25.0 250 25 (25. 120 12 12.0 =0.005 0005 005 questionnaires 91.43% 9143 91 43 (91.43 1875 75 18.75% <0.0010, 00010 <0.0010 , 0010 <0.0010) 60.0% 600 60 (60.0 00 0.0% <0.001, 0001 <0.001 001 <0.001) 100.0% 1000 100 (100.0 750 75.0% =0.007 0007 007 28.57% 2857 28 57 (28.57 =0.017. 0017 =0.017 . 017 =0.017) 462 46 2 46. ORIC 95 823 23 8.2 259.49. 25949 259.49 259 49 259.49) 86.3%, 863 86 3 (86.3% 91.4%, 914 91.4% 4 (91.4%) 81.2%. 812 81.2% 81 (81.2%) 20 6 68.8 1.3 13 (1. 09 9 0.9 =0.03 003 03 25. (25 12. =0.00 000 91.43 (91.4 187 7 18.75 60.0 (60. 0.0 <0.00 100.0 10 (100. 75.0 28.57 285 (28.5 =0.01 01 82 8. 2594 259.4 86.3% (86.3 91.4 (91.4% 81.2 (81.2% 68. 1. (1 0. =0.0 (2 (91. 18.7 60. (60 <0.0 100. (100 75. 28.5 (28. 259. 86.3 (86. 91. 81. (81.2 ( =0. (91 18. (6 <0. (10 28. (28 86. (86 (81. =0 (9 <0 (8 (81 <