SLE Patients May Be at Higher Risk of Atherosclerosis

Atherosclerosis is highly prevalent among Danish patients with systemic lupus erythematosus (SLE) without any history of cardiovascular disease (CVD), researchers at Odense University Hospital reported, further noting that the evaluation of more than one vascular territory was necessary to diagnose the disease in these patients.

Their research paper, titled “Coronary, Carotid, and Lower-extremity Atherosclerosis and Their Interrelationship in Danish Patients with Systemic Lupus Erythematosus,” was published in The Journal of Rheumatology.

According to the Alliance for Lupus Research, people with systemic lupus erythematosus (SLE) have a significantly increased risk of atherosclerosis, or hardening of the arteries, and other cardiovascular-related conditions such as thrombosis (blood clotting abnormalities), with some studies reporting a risk 50 times higher for people with lupus.

Researchers sought to fill a gap in the knowledge linking SLE and atherosclerosis, as this higher risk correlation has been predominantly demonstrated in non-European SLE studies and few studies have included more than one imaging modality. The team evaluated the prevalence of atherosclerosis in three vascular territories, the coronary, carotid, and lower-extremity arteries, in the Danish population. The evaluation included 103 SLE patients (average age, 49.2 years) with no history of cardiovascular disease. The patients were screened for coronary artery calcification (CAC), evaluated through computed tomography (CT), carotid artery thickening and plaque through B-mode ultrasound and SLE disease activity, anticoagulant use, and the presence of antiphospholipid antibodies, a known risk factor.

Results showed that 42.7% of patients presented some degree of CAC and 15.5% presented plaque at any vascular location, while atherosclerosis in the lower extremities was identified in 16 patients. Overall, the prevalence of atherosclerosis in any vascular territory was of 41%. The cardiovascular mortality risk was considered low among patients without atherosclerosis, remaining low for 36% of patients with atherosclerosis, but high or very high for among patients with atherosclerosis.

“Atherosclerosis is highly prevalent among Danish patients with SLE without prior CVD. Screening for atherosclerosis in 1 vascular territory is insufficient in diagnosing atherosclerosis in patients with SLE,” the authors conclude in their study.