Prevalence and Correlates of Accelerated Atherosclerosis in Systemic Lupus Erythematosus

Roman, Mary J.; Shanker, Beth‐Ann; Davis, Adrienne; Lockshin, Michael D.; Sammaritano, Lisa R.; Simantov, Ronit; Crow, Mary K.; Schwartz, Joseph E.; Paget, Stephen; Devereux, Richard B.; Salmon, Jane E.

doi:10.1056/nejmoa035471

Cited by 1,235 publications

(489 citation statements)

References 28 publications

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“…Cross-sectional studies of patients with differing degrees of disease activity and steroid dosages have generally demonstrated elevated mean triglyceride levels, while total cholesterol levels have been either normal or elevated. Similar variability in low-density lipoprotein (LDL) cholesterol and HDL cholesterol levels have been seen (13,16,23,24,27,(31)(32)(33). None of the studies published thus far have reported longitudinal data on lipid levels at fixed time points or evaluated large numbers of pediatric patients at presentation and at times of differing disease activity in order to better differentiate the effects of disease activity and steroid treatment.…”

mentioning

confidence: 76%

The complex nature of the interaction between disease activity and therapy on the lipid profile in patients with pediatric systemic lupus erythematosus

Sarkissian¹,

Beyenne²,

Feldman³

et al. 2006

Arthritis & Rheumatism

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Objective. To determine the prevalence of lipid abnormalities at different times and to determine the influence of both the disease and corticosteroid therapy on lipid abnormalities in pediatric patients with systemic lupus erythematosus (SLE).Methods. Lipid measurements were obtained in an inception cohort of 139 pediatric patients with SLE (114 females). Fasting levels of total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, and highdensity lipoprotein (HDL) cholesterol in the SLE patients were compared with those in age-and sex-matched control subjects. Disease activity levels and medication dosages were obtained at the time of lipid measurements.Results. At the time of diagnosis, the mean levels of total cholesterol, LDL cholesterol, and triglycerides were highest, whereas the mean levels of HDL cholesterol were lowest. The percentage of patients with abnormal triglyceride values was highest at diagnosis, decreased at year 1, and then remained relatively constant thereafter. The mean total cholesterol and LDL cholesterol levels decreased at year 1 as compared with the time of diagnosis and then remained relatively constant. The lowest mean HDL cholesterol levels were found at the time of diagnosis, and these values rose with time. Comparison of lipid levels at different prednisone dosages and disease activity levels revealed that changes in triglyceride levels were mainly associated with changes in disease activity, changes in both total cholesterol and LDL cholesterol levels were associated with changes in the prednisone dosage and not disease activity, and low levels of HDL cholesterol were associated with active SLE, whereas the prednisone dosage was associated with increased levels of HDL cholesterol.Conclusion. Factors intrinsic to SLE appear to alter lipid levels. Control of SLE may be the most important factor in improving abnormal lipid profiles, and paradoxically, prednisone therapy may improve abnormal lipid levels.

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mentioning

confidence: 76%

The complex nature of the interaction between disease activity and therapy on the lipid profile in patients with pediatric systemic lupus erythematosus

Sarkissian¹,

Beyenne²,

Feldman³

et al. 2006

Arthritis & Rheumatism

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“…Despite a high level of scientific interest in blood rheology and cardiovascular disease in the general population, little work has focused on the role of rheologic variables in lupus, a disease characterized by premature atherothrombotic events (6,7,34,35). Because traditional risk factors do not fully explain the high rate of atherosclerotic disease in patients with SLE, nontraditional risk factors warrant greater scrutiny.…”

Section: Discussionmentioning

confidence: 99%

Whole blood viscosity and arterial thrombotic events in patients with systemic lupus erythematosus

Booth¹,

Chohan²,

Curran³

et al. 2007

Arthritis & Rheumatism

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Objective. To determine if whole blood viscosity (WBV), a rheologic variable contributing to risk of myocardial infarction and stroke in the general population, is elevated in patients with systemic lupus erythematosus (SLE), particularly SLE patients with a history of thrombotic or atherothrombotic events. Because the high rates of arterial and venous thrombosis in lupus cannot be explained by traditional risk factors, elevated WBV may be an easily measurable nontraditional risk factor to identify SLE patients at high risk for thrombotic events. Methods. Sixty SLE patients (30 with a history of a thrombotic event) and 20 matched controls were recruited into the study. The thrombosis group was further subdivided into an arterial thrombosis group (n ‫؍‬ 17). WBV values were determined at 9 different shear rates (1, 2, 5, 10, 50, 100, 150, 300, and 1,000 seconds ؊1 ). WBV was then compared between groups by repeated-measures analysis of variance. Results. SLE patients with a history of arterial events had significantly elevated WBV relative to either controls (P ‫؍‬ 0.022) or SLE patients without arterial events (P ‫؍‬ 0.014). WBV in the total SLE group did not differ from controls. Differences in WBV were most prominent at lower shear rates (1, 2, 5, 10, 50, and 100 seconds ؊1 ). Anticoagulation, prednisone dose, and antiphospholipid antibodies did not significantly impact WBV. Conclusion. Our study demonstrated that WBV is selectively elevated in patients with SLE with a history of arterial events. Although this association is striking, longitudinal studies are needed to assess the positive predictive value of WBV for atherothrombotic events in SLE.

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“…Furthermore, patients with ARDs might develop subclinical CVDs, which are also increased in patients with RA and SLE. Carotid artery plaque, carotid intima-medial thickness (IMT) and coronary calcification are more prevalent in both RA and SLE (Ferrante, 2009;Kumeda, 2002;Asanuma, 2003;Roman et al, 2003;Roman et al, 2006;Ahmad et al, 2007;Wang et al, 2009).…”

Section: Ards and High Prevalence Of Cvdsmentioning

confidence: 99%

Endothelial progenitor cells: Are they displaying a function in autoimmune disorders?

Ferrante

Guggino

Liberto

et al. 2016

Mechanisms of Ageing and Development

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a b s t r a c tEndothelial Progenitor Cells (EPCs) are bone marrow derived cells able to differentiate in mature endothelial cells (EC) contributing to the generation of new vessels, connecting to fibronectin, and forming colonies and/or colony forming units.Since circulating EPCs can be actively considered part of endothelial damage in several cardiovascular diseases and autoimmune disorders the possibility to have a measure for endothelium damage should be considered of interest to predict the patient out-come. At the same time the EPCs proliferative and regenerative role could be considered for therapeutic applications.

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Prevalence and Correlates of Accelerated Atherosclerosis in Systemic Lupus Erythematosus

Cited by 1,235 publications

References 28 publications

The complex nature of the interaction between disease activity and therapy on the lipid profile in patients with pediatric systemic lupus erythematosus

The complex nature of the interaction between disease activity and therapy on the lipid profile in patients with pediatric systemic lupus erythematosus

Whole blood viscosity and arterial thrombotic events in patients with systemic lupus erythematosus

Endothelial progenitor cells: Are they displaying a function in autoimmune disorders?

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