RESEARCH - Progression of carotid intima-media thickness and plaque in women with SLE

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Arthritis Rheum. 2008 Feb 29;58(3):835-842 [Epub ahead of print]

Progression of carotid intima-media thickness and plaque in women with

systemic lupus erythematosus.

T, Sutton-Tyrrell K, Wildman RP, Kao A, Fitzgerald SG, Shook

B, RP, Kuller LH, Brockwell S, Manzi S.

University of Pittsburgh, Pittsburgh, Pennsylvania.

OBJECTIVE: Women with systemic lupus erythematosus (SLE) are at high

risk of cardiovascular disease (CVD). The goals of this study were to

determine the extent of atherosclerotic progression among women with

SLE compared with a group of healthy controls and to determine whether

factors attributed to SLE or its treatment were associated with

atherosclerotic progression independent of traditional CVD risk

factors. METHODS: A longitudinal study of women with SLE from the

Pittsburgh Lupus Registry was conducted. Women 18 years of age and

older (n = 217) underwent carotid ultrasound at baseline and at

followup, an average of 4.19 years later. Clinical, serologic, and

SLE-related factors, and disease treatment were evaluated. Outcomes

were changes in carotid intima-media thickness (IMT) and plaque.

Progression of CVD in a sample of women without lupus was used for

comparison. RESULTS: The patients' mean +/- SD age at baseline was

45.1 +/- 10.3 years, and the mean +/- SD IMT progression rate was

0.011 +/- 0.03 mm per year. After controlling for traditional CVD risk

factors, higher serum creatinine levels were associated with IMT

progression (P = 0.0006). Plaque prevalence was 31% at baseline and

40% at followup; plaque progression occurred in 27% of the patients.

Higher serum C3 levels and immunosuppressant use at baseline were

related to plaque progression (P = 0.04 and P = 0.02, respectively)

independent of traditional CVD risk factors. The plaque progression

rate was higher than, and the IMT progression rate was similar to,

those in the control group.

CONCLUSION: SLE patients have accelerated plaque progression compared

with controls. SLE-related risk factors are associated with the

progression of IMT and plaque after controlling for traditional CVD

risk factors. Carotid B-mode ultrasound may serve as a surrogate end

point in SLE intervention trials and clinically to track SLE

management.

PMID: 18311797

http://www.ncbi.nlm.nih.gov/pubmed/18311797

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