Sao Paulo Med. J.

2005

DOI: 10.1590/s1516-31802005000300010

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Atherosclerotic plaque in carotid arteries in systemic lupus erythematosus: frequency and associated risk factors

Alexandre Wagner Silva de Souza

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,

Francisca Satomi Hatta

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,

³

et al.

Abstract: Young patients with SLE present higher prevalence of carotid plaque than controls. SLE diagnosis was a significant risk factor for carotid atherosclerosis.

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Cited by 32 publications

(26 citation statements)

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“…Um estudo brasileiro identificou obesidade, definida também como IMC > 30, em 19,5% de pacientes com LES com média de idade de 34 anos (9) , freqüência semelhante à relatada na presente pesquisa (20,9%). A obesidade abdominal faz parte da sín-drome metabólica, caracterizada pela resistência periférica à insulina e associada ao risco de DAC (16) .…”

Section: Discussionunclassified

“…A taxa de mortalidade secundária à doença aterosclerótica no lúpus varia entre 6% e 16% (5) dos casos, podendo chegar a 30% (6) . A freqüência de DAC em várias coortes foi determinada entre 4,9% e 10% (4,(6)(7)(8)(9) . Manzi et al (4) calcularam que o risco de uma paciente com LES, entre 35 e 44 anos de idade, apresentar infarto agudo do miocárdio é aproximadamente 50 vezes maior do que o risco de uma mulher da população geral na mesma faixa.…”

Section: Introductionunclassified

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Freqüência de doença cardiovascular aterosclerótica e de seus fatores de risco em pacientes com lúpus eritematoso sistêmico

et al. 2007

Rev. Bras. Reumatol.

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Introduction: the pathogenesis of coronary disease in systemic lupus erythematosus patients is not completely understood. Risk factors associated with lupus or its treatment may be associated with traditional risk factors for coronary disease. Such risk factors are more common in patients with lupus. Objective: to determine the frequency of cardiovascular disease and traditional risk factors in patients with systemic lupus erythematosus at Rheumatology Division of Hospital das Clínicas of Minas Gerais Federal University. Methods: 172 patients with systemic lupus erythematosus were evaluated. Cardiovascular events, traditional risk factors and clinical-laboratorial findings were investigated in this cross-sectional research. Results: the mean age (SD) of the patients was 38.5 years (11.2 years). 95.9% were female and 64.5% were non white. Cardiovascular disease was identified in 8 patients (4.7%), with 11 different diagnoses. Three patients had coronary insufficiency, three had stroke and five had peripheral arterial disease. Systemic arterial hypertension was the most frequent risk factor (48.8%), followed by dyslipidemia in 70 patients (40.7%) and hypertriglyceridemia in 51 patients (29.7%). LDL-c ≥ 100 mg/dl was found in 77 patients (44.8%). Among 165 female patients, 67 (40.6%) had menopause, 43.3% of them with early menopause. Conclusion: the present study describes the frequency of risk factors for coronary artery disease in a Brazilian sample of lupus patients. The impact of recognition and management of those risk factors in prevention of cardiovascular events should be object of others studies.

“…Um estudo brasileiro identificou obesidade, definida também como IMC > 30, em 19,5% de pacientes com LES com média de idade de 34 anos (9) , freqüência semelhante à relatada na presente pesquisa (20,9%). A obesidade abdominal faz parte da sín-drome metabólica, caracterizada pela resistência periférica à insulina e associada ao risco de DAC (16) .…”

Section: Discussionunclassified

“…A taxa de mortalidade secundária à doença aterosclerótica no lúpus varia entre 6% e 16% (5) dos casos, podendo chegar a 30% (6) . A freqüência de DAC em várias coortes foi determinada entre 4,9% e 10% (4,(6)(7)(8)(9) . Manzi et al (4) calcularam que o risco de uma paciente com LES, entre 35 e 44 anos de idade, apresentar infarto agudo do miocárdio é aproximadamente 50 vezes maior do que o risco de uma mulher da população geral na mesma faixa.…”

Section: Introductionunclassified

Freqüência de doença cardiovascular aterosclerótica e de seus fatores de risco em pacientes com lúpus eritematoso sistêmico

et al. 2007

Rev. Bras. Reumatol.

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Introduction: the pathogenesis of coronary disease in systemic lupus erythematosus patients is not completely understood. Risk factors associated with lupus or its treatment may be associated with traditional risk factors for coronary disease. Such risk factors are more common in patients with lupus. Objective: to determine the frequency of cardiovascular disease and traditional risk factors in patients with systemic lupus erythematosus at Rheumatology Division of Hospital das Clínicas of Minas Gerais Federal University. Methods: 172 patients with systemic lupus erythematosus were evaluated. Cardiovascular events, traditional risk factors and clinical-laboratorial findings were investigated in this cross-sectional research. Results: the mean age (SD) of the patients was 38.5 years (11.2 years). 95.9% were female and 64.5% were non white. Cardiovascular disease was identified in 8 patients (4.7%), with 11 different diagnoses. Three patients had coronary insufficiency, three had stroke and five had peripheral arterial disease. Systemic arterial hypertension was the most frequent risk factor (48.8%), followed by dyslipidemia in 70 patients (40.7%) and hypertriglyceridemia in 51 patients (29.7%). LDL-c ≥ 100 mg/dl was found in 77 patients (44.8%). Among 165 female patients, 67 (40.6%) had menopause, 43.3% of them with early menopause. Conclusion: the present study describes the frequency of risk factors for coronary artery disease in a Brazilian sample of lupus patients. The impact of recognition and management of those risk factors in prevention of cardiovascular events should be object of others studies.

“…2 In fact, studies have demonstrated that carotid atherosclerosis, 3 coronary calcification 4 and cardiovascular events 5,6 are more frequently observed in these patients. These latter risks may cumulatively reach an excess of >50-fold in younger women with lupus.…”

Section: Introductionmentioning

confidence: 98%

Premature coronary artery calcification is associated with disease duration and bone mineral density in young female systemic lupus erythematosus patients

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³

et al. 2009

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Our objective was to evaluate the relevance of traditional and disease-related cardiovascular risk factors and of bone mineral density for premature coronary artery calcification in young patients with systemic lupus erythematosus. Ninety-four female patients with systemic lupus erythematosus with disease durations >5 years and <45 years were consecutively selected. Cardiovascular risks (diabetes mellitus, arterial hypertension, dyslipoproteinemia, smoking, family history, body mass index, ovarian and renal insufficiency) and systemic lupus erythematosus-related risk factors (disease duration, ACR criteria, modified SLICC/ ACR, SLEDAI and treatment) were evaluated. Bone mineral density was assessed by dual X-ray absorptiometry. Coronary artery calcification was determined by computed tomography. Coronary artery calcification was identified in 12 (12.7%) patients and was associated with a higher frequency of patients with cardiovascular risks (p = 0.001), higher number of cardiovascular risks (p = 0.002), age (p = 0.025), disease duration (p = 0.011) and SLICC (p=0.011). Individual analysis of cardiovascular risks demonstrated that menopause (p = 0.036), dyslipidemia (p = 0.003) and hypertension (p = 0.006) were significantly associated with coronary artery calcification. In addition, coronary artery calcification was associated with a lower whole body bone mineral density (p = 0.013). Multiple logistic regression analysis using cardiovascular risks, age, disease duration, SLICC and whole body bone mineral density revealed that only disease duration (p = 0.038) and whole body bone mineral density (p = 0.021) remained significant for coronary artery calcification. In conclusion, we found that disease duration and decreased bone mineral density are independent predictors for premature coronary calcification in young women with systemic lupus erythematosus, suggesting a common underlying mechanism.

“…In another study on Egyptian SLE patients, subclinical carotid plaque was found in only 5% of the patients [12]. In another study on SLE and the risk of carotid atherosclerosis, 50% of the patients had carotid plaque [43]. Cardiovascular disease is a major complication of lupus and a leading cause of death.…”

Section: Discussionmentioning

confidence: 99%

Intima-media thickness in secondary anti-phospholipid syndrome patients: Impact of disease activity

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²

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³

2015

The Egyptian Rheumatologist

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Aim of the work: To assess the carotid intima-media thickness (IMT) and plaque formation in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS) by doppler ultrasonography and to correlate it with the clinical features, disease activity and damage.Patients and methods: Thirty-six female SLE patients with secondary APS and another 36 without were included. Thirty-six matching healthy volunteers were included as control. In patients, the disease activity and damage were assessed using the SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics (SLICC) index, respectively. Doppler ultrasound was carried out for patients and control and the IMT was measured.Results: The demographic and clinical characteristics of patients are presented. The disease activity was significantly higher in SLE patients with APS (19.7 ± 7.9) compared to SLE only patients (15.1 ± 9.2) (p = 0.03). The low density lipoprotein (LDL) was significantly increased in APS patients (p = 0.04). The IMT was comparable between both groups (0.83 ± 0.15 mm) vs (0.86 ± 0.2 mm) (p = 0.55) and both were significantly increased compared to the control (0.61 ± 0.11 mm) (p < 0.0001). The dyslipidemia present in the patients showed a significant difference in the measured lipid profile parameters (p < 0.0001). The IMT significantly correlated with the SLEDAI in both groups (p < 0.002 and <0.001 respectively).Conclusion: The increased IMT as a marker of atherosclerosis is confirmed in SLE patients with no obvious difference in those with secondary APS. The link between the increased IMT and disease activity favors the role of disease-specific potential risk factors, in addition to the traditional conventional ones, in the development of atherosclerosis.

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