Predictors of cardiovascular damage in patients with systemic lupus erythematosus: data from LUMINA (LXVIII), a multiethnic US cohort

Pons-Estel, Guillermo J.; González, Luis Alonso; Zhang, Jie; Burgos, Paula I.; Reveille, John D.; Vilá, Luis M.; Alarcón, Graciela S.

doi:10.1093/rheumatology/kep102

Cited by 105 publications

(103 citation statements)

References 45 publications

(52 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1 The frequency of heart involvement in SLE patients can differ, depending on whether clinical manifestations (5-10% of patients) or objective data on subclinical cardiac involvement (75-95% of patients) are analysed. 2 Nowadays, subclinical cardiac pathology could be easily and objectively evaluated using two complementary non-invasive methods: echocardiography -a sensitive tool for assessing the heart structure and function, and perfusion scintigraphy -with which blood flow abnormalities through the myocardium can be detected. 3 Interestingly, while conventional risk factors of coronary artery disease (diabetes, hypertension, tobacco use, hyperlipidaemia, sedentary lifestyle) are common in SLE patients, they alone fail to explain the increased frequency of cardiovascular morbidity in this group of subjects.…”

mentioning

confidence: 99%

Association of heart structure and function abnormalities with laboratory findings in patients with systemic lupus erythematosus

Płazak

Gryga

Milewski

et al. 2011

Lupus

View full text Add to dashboard Cite

Conventional risk factors of coronary artery disease fail to explain the increased frequency of cardiovascular morbidity in patients with systemic lupus erythematosus (SLE). The study was conducted to determine possible association between the heart structure and function abnormalities with established prognostic value assessed by non-invasive imaging techniques and markers of autoimmune and inflammatory phenomena typical for SLE. Echocardiography and single photon emission computerized tomography (SPECT; Tc-99m-MIBI) at rest were performed in 60 SLE patients in a stable clinical condition of their disease. Laboratory evaluation included serum levels of C-reactive protein (CRP), complement C3c and C4 components and antiphospholipid antibodies (aPL). The latter included serum anticardiolipin (aCL) and anti-β2-glycoprotein I (antiβ2GPI) antibodies, both of IgG and IgM class, and lupus anticoagulant (LA) in plasma. Echocardiography revealed pathologic thickening of valvular leaflets and/or pericardium in more than 60% of patients. Right ventricular systolic pressure (RVSP) was elevated (>30 mmHg) in 16.7%. Myocardial perfusion defects were present in 36.7% of patients, despite normal ECG recordings and a lack of clinical symptoms of myocardial ischaemia. There was a significant association between thickening of valvular leaflets and/or pericardium and high CRP and low C3c and C4 concentrations. On the other hand, increased RVSP and the presence of myocardial perfusion defects were associated with the presence of anticardiolipin and antiβ2GPI antibodies of the IgG class. Increased anticardiolipin IgG levels predicted perfusion defects in SPECT study with 100% sensitivity and 68% specificity, whereas elevated antiβ2GPI IgG levels predicted RVSP elevation (>30 mmHg) with 100% sensitivity and 78% specificity. In stable SLE patients pericardial and valve abnormalities may be associated with markers of an ongoing inflammation. Also, pulmonary systolic pressure elevation and myocardial perfusion defects are combined with elevated levels of anticardiolipin and antiβ2GPI antibodies of the IgG class. These results indicate that even clinically silent pulmonary hypertension and myocardial perfusion defects in SLE patients could be causally related to the presence of antiphospholipid antibodies.

show abstract

mentioning

confidence: 99%

Association of heart structure and function abnormalities with laboratory findings in patients with systemic lupus erythematosus

Płazak

Gryga

Milewski

et al. 2011

Lupus

View full text Add to dashboard Cite

show abstract

“…We also confirm that cardiovascular risk factors are more prevalent in patients with SLE. While prior studies have focused on specific cardiovascular events such as myocardial infarction and cardiovascular death, data pertaining to HF as an independent outcome are scarce 5 14 15. To our knowledge, this is the first large-scale study to examine risk factors for HF in patients with SLE.…”

Section: Discussionmentioning

confidence: 95%

Incidence and risk of heart failure in systemic lupus erythematosus

Kim

Al‐Kindi

Jandali

et al. 2016

Heart

View full text Add to dashboard Cite

show abstract

“…A recent study from Pons-Estel et al with 637 SLE patients from the LUMINA cohort attempted to determine predictors of cardiovascular damage, defined as angina or coronary artery by-pass surgery, myocardial infarction and/or congestive heart failure [62] Data from studies performed in patients with other autoimmune disorders suggest an improvement in glucose metabolism, with a better control of type 2 diabetes mellitus and also preventing the development of this illness [63]. The study by Wasko et al in [64].…”

Section: Clinical Effects Of Antimalarialsmentioning

confidence: 99%