Patients with systemic lupus erythematosus (SLE) have higher incidence of subclinical atherosclerosis markers compared to heathy people, a French study shows.
Understanding how cardiovascular disease develops in lupus patients may help establish better, personalized therapeutic strategies, including in patients who have no history of cardiovascular disease.
The study, “Assessment of subclinical atherosclerosis in systemic lupus erythematosus: a systematic review and meta-analysis,” was published in the journal Joint Bone Spine.
Early mortality in lupus patients is commonly associated with complications related to disease progression. But in older patients, mortality has been associated with the occurrence of cardiovascular events. In fact, the mortality rates of lupus patients due to cardiovascular disease have increased in the past years.
While it is not fully understood how lupus contributes to the development of cardiovascular disease, it has become clear that early detection and treatment in this patient population is very important.
In an attempt to better understand how cardiovascular disease affects lupus patients, a French research team studied the atherosclerosis rates in lupus patients versus healthy people.
Atherosclerosis is characterized by the buildup of a plaque inside arteries, making them narrower and preventing the blood from flowing normally.
The team pooled data from 68 studies containing information on carotid intimamedia thickness (CIMT), carotid plaque presence, or flow-mediated dilatation (FMD), measures commonly used to assess atherosclerosis. The pooled data comprised information from 5,248 lupus patients and 3,997 healthy volunteers.
Lupus patients were found to have a significantly higher CIMT, which may represent an increased risk for myocardial infarction and stroke. Lupus patients also were twice as likely to have carotid plaque.
The results, according to the study, showed “the prevalence of subclinical atherosclerosis was higher in the SLE patients than in the healthy controls. These results highlight the necessity of both a tight control of [cardiovascular] risk factors and an evaluation of subclinical atherosclerosis in SLE patients.”
Additional studies evaluating the factors that accelerate atherosclerosis in lupus are now required to improve patient care and reduce cardiovascular disease risk in this population.
“Recommendations for a better understanding and management of the precocious cardiovascular burden in SLE patients should be released,” the researchers concluded.