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

Abstract

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.

Atacicept in combination with MMF and corticosteroids in lupus nephritis: results of a prematurely terminated trial

“…In addition, hypogammaglobulinemia has been reported in approximately half of renal transplant patients receiving MMF in combination with CS [8]. It is of interest to note that an increased risk of infection has been observed in other LN studies during the induction phase with MMF and high-dose CS, compared with the maintenance phase [9,10]. The results reported here raise the possibility that this increased risk may be associated with severe hypogammaglobulinemia.…”

Prevalence and Possible Risk Factors of Low Bone Mineral Density in Untreated Female Patients with Systemic Lupus Erythematosus

“…On the other hand, women with cardiovascular disease have increased risk of osteoporotic fracture [ 28 ]. In patients with SLE, decreased BMD is an independent predictor for premature coronary calcification [ 29 ]. The definite link between atherosclerosis and osteoporosis suggested that they may share common risk factors.…”

Treatment of Mild, Moderate, and Severe Lupus Erythematosus: Focus on New Therapies

“…Treatment failure was defined by one of the following components: renal flare, sustained doubling of serum creatinine, initiation of rescue therapy for nephritis, end stage renal disease, or death. The cumulative incidence of treatment failure at 36 months was 16% in MMF group vs. 32% in the azathioprine group [32]. This difference was consistent among all racial groups.…”