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Published on: December 7, 2013

Atherosclerosis in systemic lupus erythematosus

George Stojan1, Michelle Petri

  • 1Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Journal of Cardiovascular Pharmacology
|June 25, 2013
PubMed

Insights

Systemic lupus erythematosus (SLE) patients face accelerated atherosclerosis and mortality. While traditional risk factors are important, SLE-specific factors and certain treatments like hydroxychloroquine are key for managing cardiovascular risk in these patients.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Immunology

Background:

  • Accelerated atherosclerosis is a primary cause of mortality in Systemic Lupus Erythematosus (SLE) patients.
  • Traditional cardiovascular risk factors inadequately explain the elevated risk in SLE.
  • SLE-specific factors, including disease activity, duration, corticosteroid use, and antiphospholipid antibodies, significantly contribute to cardiovascular risk.

Purpose of the Study:

  • To review the cardiovascular risk factors and management strategies in patients with Systemic Lupus Erythematosus.
  • To evaluate the efficacy of various therapeutic interventions on cardiovascular outcomes in SLE.

Main Methods:

  • Literature review of studies on cardiovascular disease in SLE.
  • Analysis of traditional and SLE-specific risk factors for atherosclerosis.
  • Evaluation of pharmacological interventions, including statins, hydroxychloroquine, mycophenolate mofetil, vitamin D, and homocysteine treatments.

Main Results:

  • Statins show limited efficacy in preventing cardiovascular outcomes in SLE populations.
  • Hydroxychloroquine demonstrates cardioprotective effects.
  • Mycophenolate mofetil may reduce cardiovascular events, supported by preclinical and transplant data.
  • The benefits of vitamin D supplementation and hyperhomocysteinemia treatment remain debated but are considered optional therapies due to safety profiles.

Conclusions:

  • Systemic Lupus Erythematosus is considered a coronary heart disease equivalent, necessitating aggressive management of all risk factors.
  • Hydroxychloroquine and potentially mycophenolate mofetil are beneficial for cardiovascular health in SLE patients.
  • Further research is needed to clarify the role of vitamin D and homocysteine management in SLE cardiovascular disease prevention.

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