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Myocardial Infarction in Systemic Lupus Erythematosus - the Sex-Specific Risk Profile

Marija Vavlukis1, Daniela Pop-Gjorcevab2, Lidija Poposka1

  • 1University Clinic for Cardiology, Medical Faculty, Ss' Cyril and Methodius University, Skopje, North Macedonia.

Current Pharmaceutical Design
|December 11, 2020
PubMed

Insights

Systemic lupus erythematosus (SLE) significantly increases myocardial infarction risk through various mechanisms. Despite being a "female" disease, men with SLE face higher cardiovascular risks and poorer outcomes, necessitating tailored therapeutic considerations.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Immunology

Background:

  • Accelerated atherosclerosis is a common complication in patients with systemic lupus erythematosus (SLE).
  • Inflammation and infection in SLE trigger molecular mechanisms leading to early endothelial dysfunction and atherosclerosis.
  • The interplay of traditional cardiovascular risk factors and SLE-specific characteristics exacerbates atherosclerosis development.

Purpose of the Study:

  • To analyze the relationship between systemic lupus erythematosus (SLE) and cardiovascular diseases.
  • To emphasize the connection between SLE and acute myocardial infarction (MI).

Main Methods:

  • A comprehensive literature review was conducted using PubMed and Cochrane databases.
  • Keywords included SLE, atherosclerosis, atherothrombosis, coronary artery disease, myocardial infarction, prognosis, and sex specifics.

Main Results:

  • Myocardial infarction (MI) rates in SLE patients are 2- to 10-fold higher than in the general population.
  • Young women exhibit the highest relative risk for MI, while men have a 3-fold higher risk compared to women.
  • Coronary artery involvement in SLE ranges from normal artery with thrombosis to vasculitis and atherosclerosis, with varied clinical presentations based on gender and age.

Conclusions:

  • Systemic lupus erythematosus (SLE) is a significant contributor to both atherosclerotic and non-atherosclerotic mechanisms of myocardial infarction (MI).
  • Therapeutic strategies for MI in SLE patients must consider these underlying mechanisms.
  • Despite SLE being more prevalent in women, men with the disease experience increased cardiovascular risk and worse outcomes.
Abstract

Keywords:
Systemic lupus erythematosusatherosclerosisatherothrombosiscoronary artery diseasemyocardial infarctionoutcomeprevalencesex-specific risk profile.

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