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Atherosclerosis in Systemic Lupus Erythematosus

Rachel Tobin1, Nidhi Patel2, Kardie Tobb3

  • 1Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA. rstobin@emory.edu.

Current Atherosclerosis Reports
|September 28, 2023
PubMed

Insights

Systemic lupus erythematosus (SLE) patients face higher cardiovascular disease (CVD) risks. Traditional tools often miss this, necessitating early detection and management strategies for atherosclerosis in SLE.

Area of Science:

  • Rheumatology
  • Cardiology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) patients exhibit a significantly elevated risk of cardiovascular disease (CVD) compared to the general population.
  • This increased risk is notable in young female patients, a demographic not typically assessed as high-risk by conventional cardiovascular disease assessment tools.
  • Traditional risk models frequently underestimate the cardiovascular risk in SLE patients, highlighting a critical gap in patient evaluation.

Purpose of the Study:

  • To elucidate the complex pathophysiology of atherosclerosis development in patients with SLE.
  • To enhance clinical awareness regarding the intricate relationship between SLE and the heightened incidence of CVD.
  • To underscore the need for specialized approaches in assessing cardiovascular risk within the SLE cohort.

Main Methods:

  • Review of current literature on SLE and cardiovascular disease pathophysiology.
  • Analysis of factors contributing to accelerated atherosclerosis in SLE patients.
  • Discussion of the limitations of conventional cardiovascular risk assessment tools in SLE.

Main Results:

  • Cardiovascular disease risk in SLE is multifactorial, involving proatherogenic lipid profiles, immune dysregulation, inflammation, treatment side effects, and microvascular dysfunction.
  • Conventional cardiovascular risk models demonstrate suboptimal performance in identifying SLE patients with high atherosclerosis risk.
  • Non-invasive imaging techniques are crucial for detecting subclinical CVD in SLE patients, enabling proactive risk factor management.

Conclusions:

  • SLE patients face an increased burden of atherosclerotic CVD not fully explained by traditional risk factors.
  • Early identification and aggressive management of cardiovascular risk factors are imperative for SLE patients.
  • Clinicians must be vigilant for the association between SLE and accelerated atherosclerosis to ensure timely diagnosis and treatment, thereby improving patient outcomes.
Abstract

Keywords:
AtherosclerosisCoronary microvascular diseaseInflammation and cardiovascular diseaseLupus treatmentSystemic lupus erythematosus

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