Subclinical atherosclerosis in systemic lupus erythematosus patients and its relationship to disease activity and damage indices.

Abstract

To detect the incidence of premature atherosclerosis in systemic lupus erythematosus (SLE) patients and to study its association with disease activity and damage indices. This study involved 50adult female SLE patients with mean age 26.24 ± 8.63years and mean disease duration 3.44 ± 4.01years. The control group comprised 25healthy adult females. All patients were subjected to a detailed clinical examination and laboratory investigations, and full case history was recorded. Assessment of disease activity was performed according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and disease damage was assessed using the Systemic Lupus International Collaborating Clinics (SLICC) score. Bmode ultrasound was used to measure the intima-media wall thickness (IMT) and detect the presence of carotid plaques. In 15patients (30 %), positive ultrasonographic findings represented by a significant increase in IMT (> 0.9mm) could be shown; plaques were found in 3of these patients (6 %). A significant difference was found between SLE patients and controls in terms of IMT (P < 0.0001). On subgrouping the SLE patients according to their IMT, there was a significant difference between those with thickened and normal IMT in terms of SLEDAI (P < 0.0001) and SLICC (p = 0.035) scores. Subclinical atherosclerosis is frequent in SLE patients. Increased disease activity and damage are associated with the occurrence of premature atherosclerosis.