Coronary Artery Calcification Progression in Patients With Systemic Lupus Erythematosus

Area of Science:

• Cardiology
• Rheumatology
• Radiology

Background:

• Systemic lupus erythematosus (SLE) is associated with accelerated cardiovascular disease.
• Coronary artery calcification (CAC) is a marker of atherosclerosis and cardiovascular risk.
• Longitudinal data on CAC progression in SLE patients are limited.

Purpose of the Study:

• To evaluate the progression of coronary artery calcification (CAC) in a cohort of patients with systemic lupus erythematosus (SLE).
• To identify associated risk factors for CAC progression in this cohort.

Main Methods:

• A cohort of 104 SLE patients with baseline CAC screening 9 years prior underwent repeat multidetector computed tomography (MDCT) for reassessment.
• Longitudinal assessment included clinical variables, SLE serology, and cardiovascular risk factors.
• Data analyzed included cumulative disease activity, damage accrual, antiphospholipid syndrome, modified Framingham risk score, lipid profile, and menopausal status.

Main Results:

• Coronary artery calcification (CAC) was present in 17 patients (16.3%), with 10 incident cases over 9 years.
• Cumulative incidence of CAC was 9%, and incidence density was 1 per 100 person-years.
• Patients with prevalent CAC were more likely to be postmenopausal and have higher apolipoprotein B (apoB) levels compared to those without CAC. Patients with previous CAC had higher apoB levels, SLEDAI-2K AUC scores, and anticardiolipin IgG antibodies than incident cases.

Conclusions:

• Coronary artery calcification (CAC) progresses over time in patients with systemic lupus erythematosus (SLE).
• No clinical cardiovascular events were observed during the 9-year follow-up.
• Elevated apolipoprotein B (apoB) levels and postmenopausal status may be associated with CAC progression in SLE.