ON LUPUS: More on vascular disease
Preclinical vascular disease in systemic lupus erythematosus and primary antiphospholipid syndrome.S Jiménez, MA García-Criado, D Tàssies, JC Reverter, R Cervera, MR Gilabert, D Zambón, E Ros, C Bru, J FontRheumatology (Oxford) 2005 6;44(6):756-61
A bimodal pattern of mortality in SLE was recognized nearly 30 years ago (the second peak due to cardiovascular events), accelerated atherosclerosis in SLE has only become the subject of intense investigation in the last few years. This study from Barcelona, Spain adds to this body of literature by presenting data on 70 SLE patients, 25 with antiphospholipid syndrome (APS) and 40 healthy controls. Some classical atherosclerosis risk factors were more common in the SLE patients than in the other two groups (hypertension, dyslipidemia); however, others were not (smoking, obesity, family history). Carotid intima media thickness (IMT) was comparable in the three groups, yet plaque formation occurred more frequently in the SLE patients (28.6%) than in APS patients (8%) and controls (15%) (p<0.001).>
--Graciela S. Alarcon, MD
Carotid intima thickness is a measure of the thickness of the inner lining of the carotid arteries as measured by ultrasound. This thickness correlates well with the risk of coronary artery disease. In other words, the thicker this lining, the higher your risk of heart attacks. The take home message from Dr. Alarcon's analysis is that: 1) lupus patients have a higher incidence of thickened carotid lining when compared with healthy people and therefore a higher risk of coronary artery disease, 2) the incidence is even greater if one has both lupus and antiphospholipid syndrome. This correlation is present regardless of wether or not traditional risk factors are present. Nevertheless, traditional risk factors should be addressed as aggressively as someone who is at intermediate to high risk of heart disease.
Ricardo Pocurull, MD
A bimodal pattern of mortality in SLE was recognized nearly 30 years ago (the second peak due to cardiovascular events), accelerated atherosclerosis in SLE has only become the subject of intense investigation in the last few years. This study from Barcelona, Spain adds to this body of literature by presenting data on 70 SLE patients, 25 with antiphospholipid syndrome (APS) and 40 healthy controls. Some classical atherosclerosis risk factors were more common in the SLE patients than in the other two groups (hypertension, dyslipidemia); however, others were not (smoking, obesity, family history). Carotid intima media thickness (IMT) was comparable in the three groups, yet plaque formation occurred more frequently in the SLE patients (28.6%) than in APS patients (8%) and controls (15%) (p<0.001).>
--Graciela S. Alarcon, MD
Carotid intima thickness is a measure of the thickness of the inner lining of the carotid arteries as measured by ultrasound. This thickness correlates well with the risk of coronary artery disease. In other words, the thicker this lining, the higher your risk of heart attacks. The take home message from Dr. Alarcon's analysis is that: 1) lupus patients have a higher incidence of thickened carotid lining when compared with healthy people and therefore a higher risk of coronary artery disease, 2) the incidence is even greater if one has both lupus and antiphospholipid syndrome. This correlation is present regardless of wether or not traditional risk factors are present. Nevertheless, traditional risk factors should be addressed as aggressively as someone who is at intermediate to high risk of heart disease.
Ricardo Pocurull, MD
posted by Ricardo Pocurull at 6:28 PM
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