Pattern of arterial calcification in patients with systemic lupus erythematosus

To evaluate the prevalence and pattern of arterial calcification in patients with asymptomatic systemic lupus erythematosus (SLE) compared with control subjects. SLE patients are prone to adverse cardiovascular events; however, the underlying atherosclerotic process is unknown. Multidetector computed tomography (MDCT) measured arterial calcium score (CS) reflecting underlying atherosclerosis and is closely associated with cardiovascular events.

Fifty age and sex matched SLE patients and controls were enrolled. All subjects underwent 64 slice MDCT scan to evaluate CS in coronary, carotid arteries and the aorta.

As compared with controls, SLE patients had higher mean CS and prevalence of CS > 0 across all vascular beds. After adjustment for age and sex, SLE patient odds of having CS > 0 in any vascular bed was 33.6 (95% CI: 9.5-165.2) were higher versus patients in the control group, mainly due to more prevalent coronary calcification (OR 30.0, 95% CI: 6.7-203.8). In SLE patients, the most frequent vessel with CS > 0 was coronary (42%) followed by carotid artery (24%). Further, arterial calcification occurred early involving 40% of SLE patients at age < 40 years, with increasing prevalence as age advanced.

Our study confirms that patients with SLE have significantly higher prevalence and extent of systemic arterial calcification compared with age and sex matched controls.