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Myocardial infarctions, subtypes and coronary atherosclerosis in SLE: a case-control study
Isak Samuelsson1,2,3, Ioannis Parodis4,2, Iva Gunnarsson4,2
1Unit of Rheumatology, Karolinska University Hospital, Stockholm, Sweden isak.samuelsson@ki.se.
Lupus Science & Medicine
|July 22, 2021
Summary
Myocardial infarction (MI) in Systemic Lupus Erythematosus (SLE) is often linked to coronary atherosclerosis. Early surveillance for cardiovascular disease and risk factors is crucial for patients with SLE.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Systemic Lupus Erythematosus (SLE) patients face a higher risk of myocardial infarction (MI).
- Characteristics and risk factors specific to SLE-related MIs require further investigation.
- Understanding these mechanisms is vital for improving patient outcomes.
Purpose of the Study:
- To compare the characteristics and risk factors of MI in SLE patients versus non-SLE patients.
- To elucidate the underlying mechanisms of MI in the context of SLE.
- To identify potential targets for early intervention and treatment.
Main Methods:
- Retrospective analysis of first-time MI patients within the Karolinska SLE cohort.
- Individual matching of MI-SLE patients with MI-non-SLE and non-MI-SLE controls by age and gender (1:1:1 ratio).
- Detailed medical file review and paired statistical analysis.
Main Results:
- MI-SLE patients exhibited a higher number of involved coronary arteries (p=0.04).
- Pre-existing cardiovascular and coronary artery disease were more common in MI-SLE patients.
- Lower plasma albumin levels were observed in MI-SLE patients compared to non-MI-SLE controls (p=0.002).
Conclusions:
- Myocardial infarctions in SLE are predominantly associated with coronary atherosclerosis.
- Symptomatic vascular disease frequently precedes MI in SLE patients.
- Attentive cardiovascular disease surveillance and early atheroprotective treatment are recommended for SLE patients.
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