Single photon emission computed tomography dual isotope myocardial perfusion imaging in women with systemic lupus erythematosus. II. Predictive factors for perfusion abnormalities

J Rheumatol. 2003 Feb;30(2):288-91.


Objective: We have reported that 40% of patients with systemic lupus erythematosus (SLE) had abnormal myocardial perfusion studies. Here we investigated risk factors for abnormal myocardial perfusion in a cohort of women with SLE without history of coronary artery disease.

Methods: Consecutive women with SLE followed at a large lupus clinic underwent single photon emission computed tomography dual isotope myocardial perfusion imaging (DIMPI) following pharmacological stress using dipyridamole. At the time of study each patient had a clinical and laboratory assessment performed by a standard protocol. We compared traditional risk factors as well as disease and therapy related factors in those with and without perfusion abnormalities.

Results: A total of 129 patients were studied. The mean +/- SD age was 44.8 +/- 10.9 yrs, and mean SLE Disease Activity Index was 4.2 +/- 5.1. Forty-nine (38%) patients had an abnormality of myocardial perfusion. Factors associated with an abnormal DIMPI included current hypertension (OR 2.11, p = 0.05), elevated cholesterol ever (OR 2.51, p < 0.05), and total cholesterol:high density lipoprotein-cholesterol ratio (OR 1.96 for each increase of 1.0, p < 0.008).

Conclusion: Myocardial perfusion abnormalities are common in women with SLE without known coronary artery disease (CAD), suggesting a high burden of subclinical CAD. Several metabolic and therapy related factors appear to be associated with the process of atherogenesis in SLE. These results suggest that SLE should be considered a predisposing factor for atherosclerosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / epidemiology*
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / epidemiology*
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors
  • Tomography, Emission-Computed, Single-Photon*