Risk Factors for Clinical Coronary Heart Disease in Systemic Lupus Erythematosus: The Lupus and Atherosclerosis Evaluation of Risk (LASER) Study

Abstract

Our study highlights the need for clinical vigilance to identify modifiable risk factors in the clinical setting and in particular with male patients. The pattern of organ involvement did not differ in SLE patients with CHD events. However, the higher pre-event SDI, azathioprine exposure, and pattern of damage items (disease-related rather than therapy-related) in cases suggests that a persistent active lupus phenotype contributes to CHD risk. In this regard, corticosteroids and azathioprine may not control disease well enough to prevent CHD. Clinical trials are needed to determine whether classic risk factor modification will have a role in primary prevention of CHD in SLE patients and whether new therapies that control disease activity can better reduce CHD risk.

Left ventricular myocardial ischemia in collagen disease associated with pulmonary hypertension

“…A significant inverse correlation between SLEDAI and coronary flow rate was present. In contrast, Haque et al [29] recruited 53 patients with SLE with verified clinical CAD (myocardial infarction or angina pectoris) and 96 patients with SLE without clinical CAD. Patients with SLE with clinical CAD were older at the time of event and had more exposure to all classic CAD risk factors compared with patients with SLE without clinical CAD.…”

Antiphospholipid Antibodies and Their Association with Atherosclerotic Changes in Patients with Systemic Lupus Erythematosus – Review of Literature and Own Experiences

“…Lupus anticoagulant was a sole antibody associated with myocardial infarction but there was no connection between aPL and CIMT, plaques and coronary calcification (Petri, 2010). In addition, the investigation focused on risk factors for coronary artery disease performed in SLE patients of the LASER study did not confirm any relation of aPL to cardiovascular risk (Haque et al, 2010).…”

Subclinical Atherosclerosis in Systemic Autoimmune Disorders

“…In accord with the previous findings, Haque et al compared SLE patients with verified clinical CV disease (myocardial infarction or angina pectoris) to patients without clinical CV disease. Male sex, older age, increased SLICC damage index, prior use of corticosteroids and azathioprine and more exposure to all classic CV risk factors were positively correlated with clinical CV disease (Haque, Gordon et al 2010). In our SLE cohort, IMT and the presence of plaque were both statistically significant associated with age, hypertension, triglyceridelevels and SLICC damage index score and only plaque with the levels of C3 and C4 (Giannelou 2011).…”