RESEARCH - Coronary calcium in SLE is associated with traditional cardiovascular risk factors, but not with disease activity

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J Rheumatol. 2008 May 15. [Epub ahead of print]

Coronary Calcium in Systemic Lupus Erythematosus Is Associated with

Traditional Cardiovascular Risk Factors, But Not with Disease

Activity.

Kiani AN, Magder L, Petri M.

From the Division of Rheumatology, s Hopkins University School of

Medicine, Baltimore; and the University of land, Baltimore,

land, USA.

OBJECTIVE: Cardiovascular disease is a major cause of morbidity and

mortality in systemic lupus erythematosus (SLE). The frequency of both

subclinical and clinically evident atherosclerosis is greatly

increased over healthy controls. We assessed cardiovascular risk

factors present in patients with SLE at the baseline visit in a statin

intervention trial and their correlation with coronary calcium.

METHODS: Coronary calcium was measured by helical computed tomography

(continuous volumetric data acquisition in a single breath-hold) in

200 patients with SLE enrolled in the Lupus Atherosclerosis Prevention

Study. RESULTS: Patients had a mean age of 44.3 +/- 11.4 years and

were 92% women, 61% Caucasian, 34% African American, 2% Asian, and 2%

Hispanic. Coronary calcium was found in 43%. In univariate analysis,

coronary calcification was associated with age (p = 0.0001),

hypertension (p = 0.0008), body mass index (BMI; p = 0.03),

erythrocyte sedimentation rate (ESR; p = 0.03), anti-dsDNA (p =

0.067), and lipoprotein(a) (p = 0.03). Homocysteine (p = 0.050),

high-sensitivity C-reactive protein (hsCRP; p = 0.053), and LDL (p =

0.048) had a stronger association when considered as quantitative

predictors. In a multiple logistic regression model, only age (p </=

0.0001) and body mass index (p = 0.0014) remained independent

predictors. No measure of SLE activity was associated with coronary

calcium. We also examined variables independently predictive of a

coronary calcium score > 100. Based on a multiple logistic regression

model, only age (p = 0.0017) and diabetes mellitus (p = 0.019)

remained significant independent predictors of coronary calcium > 100.

CONCLUSION: Inflammation, measured as ESR or hsCRP, is associated with

coronary calcium only in univariate analyses. Age, BMI, and diabetes

mellitus are more important associates of coronary calcium in SLE than

inflammatory markers and SLE clinical activity.

PMID: 18484694

http://www.ncbi.nlm.nih.gov/pubmed/18484694

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