Optimal Monitoring For Coronary Heart Disease Risk in Patients with Systemic Lupus Erythematosus: A Systematic Review

Tselios, Konstantinos; Sheane, Barry J.; Gladman, Dafna D.; Urowitz, Murray B.

doi:10.3899/jrheum.150460

Cited by 70 publications

(121 citation statements)

References 115 publications

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“…Obesity has been considered as a conventional risk factors of CVD including hypertension and coronary heart disease, and equally applied to patients with SLE . However, underweight patients or individuals with low fat composition had lower survival rate than normal or overweight populations, which is called the “obesity paradox”.…”

Section: Discussionsupporting

confidence: 49%

“…Many studies have reported a U‐shaped association with BMI and mortality risk from CVD, especially in east Asians . Here, BMI was negatively associated with cIMT increment, and the values of BMI in this study were significantly lower (21.0 ± 2.8 kg/m 2 ) than those in the studies (mean BMI, 25‐26 kg/m 2 ) assessing the risk of obesity to CVD . According to such studies, the patient population of some races including Koreans had less frequent obesity and lower BMI than Western patients.…”

Section: Discussionsupporting

confidence: 49%

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Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study

et al. 2019

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multiple organ involvement. 1 Since the strategies of treatment with glucocorticoids (GC) and immunosuppressive agents have been established, mortality risk has decreased in patients with SLE. 2 Infection and cardiovascular events are regarded as the most common causes of death in SLE. Cardiovascular diseases (CVD) are 5-10 times more common in patients with SLE than in the general population. 3-6 CVD in SLE occurs earlier than the general population and is affected by traditional risk factors such as obesity, diabetes, smoking and hypertension. 7,8 Disease Abstract Aim: Patients with systemic lupus erythematosus (SLE) have an increased risk of cardiovascular disease owing to an immunological abnormality, along with traditional risk factors. We found that carotid artery intima-media thickness (cIMT) and plaque were associated with age, body mass index (BMI) and disease activity in a previous study 4 years ago. Our aim was to identify risk factors associated with progression of subclinical atherosclerosis in SLE. Methods:We assessed cIMT and plaque using Doppler ultrasonography in 61 Korean women with SLE who were enrolled in the previous study 4 years ago. Results:The mean cIMT of the patients was 0.39 ± 0.09 mm; 11 patients had carotid plaques, which was similar to the results of the previous study. Twenty-one patients had increased cIMT, and new carotid plaque had developed in seven patients. Patients with increased cIMT had a lower BMI and took fewer non-steroidal anti-inflammatory drugs and higher 4 year cumulative glucocorticoid dose than patients without increased cIMT. The 4 year cumulative glucocorticoid dose was higher in patients with carotid plaque than in those without. On multivariate regression analysis, BMI (odds ratio [OR] = 0.67, P = 0.034) was associated with increased cIMT, and the 4 year cumulative glucocorticoid dose was associated with increased cIMT (OR = 6.994, P = 0.025) and carotid plaque (OR = 5.651, P = 0.031). Conclusion:This prospective follow-up study on cIMT and plaque in patients with SLE showed that low BMI and 4 year cumulative glucocorticoid dose were associated with the progression of subclinical atherosclerosis. K E Y W O R D S atherosclerosis, body mass index, carotid artery, disease activity, glucocorticoid, systemic lupus erythematosus | 1411 JUNG et al. activity, duration, specific manifestations or organ damage have been shown to increase the possibility of developing CVD. Dysfunctional immune and inflammatory response including the complement depletion, role of interferon, inflammatory cytokines and impaired endothelial function were revealed to contribute to the premature atherosclerosis development in patients with SLE. 9-12An assessment of the risk for CVD can be established using various methods, including carotid artery Doppler ultrasound, coronary artery calcium score and pulse wave velocity. Several studies assessing the risk of CVD in SLE have used different methods. 13,14 Carotid artery int...

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Section: Discussionsupporting

confidence: 49%

Section: Discussionsupporting

confidence: 49%

Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study

et al. 2019

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“…Recently published adult guidelines recommend the following: initial risk assessment of lipid profile, blood pressure and fasting glucose assessment, tobacco exposure, and plasma homocysteine evaluation; hsCRP and SLE monitoring labs at each visit, and yearly assessment of aPL antibodies. (78)** CIMT monitoring is recommended for patients with > 1 risk factor or renal disease but their utility needs to be further validated. In childhood-onset SLE, no imaging has yet proven robust for surrogate of atherosclerosis and screening guidelines remain to be developed.…”

Section: Pathogenesis Of Premature Atherosclerosis In Slementioning

confidence: 99%

Update on cardiovascular disease in lupus

Lewandowski

Kaplan

2016

Current Opinion in Rheumatology

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Purpose of Review Atherosclerotic cardiovascular disease confers significant morbidity and mortality in patients with systemic lupus erythematosus (SLE) and cannot be fully explained by traditional cardiovascular risk factors. Recent immunologic discoveries have outlined putative pathways in SLE that may also accelerate the development of atherosclerosis. Recent findings Aberrant innate and adaptive immune responses implicated in lupus pathogenesis may also contribute to the development of accelerated atherosclerosis in these patients. Defective apoptosis, abnormal lipoprotein function, autoantibodies, aberrant neutrophil responses and a dysregulated type I interferon pathway likely contribute to endothelial dysfunction. SLE macrophages have an inflammatory phenotype that may drive progression of plaque. Summary Recent discoveries have placed increase emphasis on the immunology of atherosclerotic cardiovascular disease. Understanding the factors that drive the increase risk for CVD in SLE patients may provide selective therapeutic targets for reducing inflammation and improving outcomes in atherosclerosis.

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“…Among CVD, the Myocardial Infarction (MI) is the most dreaded menace. MI is prolonged ischemia with necrosis of myocytes due to interruption of blood supply to an area of heart (Kumar and Gurusamy, 2014;Tselios et al, 2016) which results in multiple biochemical alterations (Alamgeer et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Optimization of Cardioprotective Potential of Various Concentrations of Medicinal Plants by Using Response Surface Methodology

Afsheen¹

2019

PVJ

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This study was aimed to optimize the various concentrations of selected medicinal plants through Response Surface Methodology (RSM) in conjunction with Central Composite Design (CCD) to assess their therapeutic doses for cardioprotection. Dose response relation is an important tool to study pharmacological efficacy and therapeutic index of herbal medicines. In this study the toxicological assay of various concentrations of Rauvolfia serpentina, Eletaria cardamom, Coriandrum sativum, Piper nigrum, Allium sativum, Crataegus oxyacantha and Terminalia arjuna was performed prior to in vivo evaluation. The toxicological findings depicted that none of the selected medicinal plant showed any toxicity, therefore is declared to be safe for various cardiovascular disease. Instead of in vivo trial of hundreds of the possible doses, RSM suggested only five doses (80, 110, 140, 170 and 200 mg/kg b.wt) to explore cardioprotective potential of selected medicinal plants in rats. Blood samples were taken at different time intervals to analyze the cardiac markers (CK-MB, LDH and SGOT). These cardiac markers were statistically analyzed by "RSM" to get the optimal therapeutic dose of each selected medicinal plants. The results revealed that the R.

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Optimal Monitoring For Coronary Heart Disease Risk in Patients with Systemic Lupus Erythematosus: A Systematic Review

Cited by 70 publications

References 115 publications

Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study

Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study

Update on cardiovascular disease in lupus

Optimization of Cardioprotective Potential of Various Concentrations of Medicinal Plants by Using Response Surface Methodology

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