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Updated: Jun 2, 2025
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Coronary artery calcification progression and renal involvement in patients with systemic lupus erythematosus: a
Lise Zinglersen1, Amanda Hempel Zinglersen2, Katrine Aagaard Myhr3
1Copenhagen Research Center for Autoimmune Connective Tissue Diseases (COPEACT), Copenhagen University Hospital, Rigshospitalet, Denmark. Lise.zinglersen.01@regionh.dk.
Insights
Progression of coronary artery calcification (CAC) in systemic lupus erythematosus (SLE) patients is linked to smoking, longer disease duration, and existing CAC. Renal function and myocardial infarction incidence showed inconclusive associations in this study.
Area of Science:
- Cardiology
- Rheumatology
- Nephrology
Background:
- Systemic lupus erythematosus (SLE) is associated with accelerated cardiovascular disease.
- Coronary artery calcification (CAC) is a marker of atherosclerosis and cardiovascular risk.
- Understanding factors influencing CAC progression in SLE is crucial for risk stratification.
Purpose of the Study:
- To determine if CAC progression in SLE patients is associated with traditional cardiovascular risk factors, renal function, and myocardial infarction (MI) incidence.
- To identify predictors of CAC progression in an SLE cohort.
Main Methods:
- Prospective evaluation of CAC progression using cardiac computed tomography (CT) over 5 years in 99 SLE patients.
- Multivariable Poisson regression analysis to assess associations between CAC progression and baseline factors including cardiovascular risk factors, SLE disease duration, lupus nephritis, and estimated glomerular filtration rate (eGFR).
- Analysis of MI incidence during the follow-up period.
Main Results:
- CAC progression occurred in 39% of SLE patients over 5 years.
- CAC progression was significantly associated with ever smoking (RR 1.69), longer SLE disease duration (RR per year 1.03), and baseline CAC presence (RR 2.52).
- Associations with renal involvement (eGFR categories) and MI incidence were inconclusive.
Conclusions:
- Smoking, longer SLE duration, and baseline CAC predict CAC progression in SLE patients.
- The study did not establish clear associations between CAC progression and renal function or MI incidence in this cohort.
- Further research is needed to clarify the role of renal factors and MI risk in CAC progression among SLE patients.
Abstract:
To investigate if progression of coronary artery calcification (CAC) in patients with systemic lupus erythematosus (SLE) is associated with renal and traditional cardiovascular risk factors as well as incidence of myocardial infarctions. CAC progression was evaluated by cardiac computed tomography (CT) at baseline and after 5 years. Multivariable Poisson regression was applied to investigate associations between CAC progression and baseline values for traditional cardiovascular risk factors, CAC, SLE disease duration, lupus nephritis, and renal function. Regarding renal function, three groups were defined based on eGFR. Further, we analysed association between CAC progression and myocardial infarction during follow-up. Of the 147 SLE patients, 99 had cardiac CT at baseline and 5-year follow-up, with a total of 502 patient-years. At baseline, their median age was 47 years, median SLE disease duration was 14 years, 88% were women, 58% had lupus nephritis, and the median eGFR was 99 mL/min/1.73m2. 38/99 (39%) had CAC progression. CAC progression was associated with smoking (ever) (relative risk [RR] 1.69, CI95% 1.19-2.40), SLE disease duration (RR per year 1.03, CI95% 1.01-1.04), and CAC presence (RR 2.52, CI95% 1.68-3.78) at baseline. During follow-up, myocardial infarction occurred in three (7.9%) CAC progressors and in two (3.3%) patients who did not have CAC at any time (RR 2.1, CI95% 0.0-5.5). In this study, progression of CAC was associated with smoking, SLE disease duration and the prior presence of CAC, but it was inconclusive as to associations with renal involvement and incidence of MI.
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