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Epidemiology of atherosclerosis in systemic lupus erythematosus

Mandana Nikpour1, Murray B Urowitz, Dafna D Gladman

  • 1University of Toronto Lupus Clinic and the Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Ontario, Canada.

Current Rheumatology Reports
|August 21, 2009
PubMed

Insights

Systemic lupus erythematosus (SLE) patients face higher coronary event risks, partly due to traditional factors. Novel markers and detecting subclinical atherosclerosis are key to understanding and preventing heart disease in SLE.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Patients with systemic lupus erythematosus (SLE) exhibit a substantially elevated risk of atherosclerotic coronary events.
  • Traditional risk factors like hypertension and hypercholesterolemia incompletely explain this heightened coronary disease risk in SLE.
  • Disease-specific and treatment-related factors also contribute significantly to cardiovascular risk in SLE patients.

Purpose of the Study:

  • To investigate novel markers of coronary risk in patients with SLE.
  • To evaluate methods for detecting subclinical atherosclerosis in SLE.
  • To understand the predictive value of myocardial perfusion defects for coronary events in SLE.

Main Methods:

  • Utilized scintigraphic myocardial perfusion imaging to assess subclinical atherosclerosis.
  • Analyzed the predictive capacity of myocardial perfusion defects for coronary events.
  • Compared the predictive value of these defects against traditional Framingham risk factors.

Main Results:

  • Scintigraphic myocardial perfusion defects were found to be predictive of future coronary events in SLE patients.
  • This predictive ability was independent of traditional Framingham risk factors.
  • Current evidence does not yet demonstrate a clear reduction in coronary events through aggressive treatment of reversible risk factors like lipids and blood pressure.

Conclusions:

  • Accelerated atherosclerosis in SLE is influenced by factors beyond traditional risk assessment.
  • Subclinical atherosclerosis detection, such as via myocardial perfusion imaging, offers valuable prognostic information in SLE.
  • Further research is needed to elucidate specific risk factors and effective preventive strategies for cardiovascular disease in SLE.

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