Carotid atherosclerotic alterations in systemic lupus erythematosus patients treated at a Brazilian university setting

Lupus. 2008 Feb;17(2):105-13. doi: 10.1177/0961203307085312.

Abstract

To determine the frequency of carotid plaque and intima-media thickness (IMT) in patients with systemic lupus erythematosus (SLE) and their association with risk factors in a Brazilian university setting. Carotid plaque and IMT were identified and measured by ultrasonography. Traditional risk factors and lupus-related factors were analysed. One hundred and seventy-two patients (women = 96%, age = 38 +/- 11 years) were evaluated. The frequency of carotid plaque was 9.3%. The median (IR) IMT was 0.60 mm (0.54-0.71 mm). Age, family history (FH) of premature coronary disease, low-density cholesterol (LDL-c) >100 mg/dL, hypertriglyceridemia, diabetes, hypertension, smoking, postmenopause, number of risk factors, Framingham risk score, age at diagnosis, duration of lupus, mucocutaneous manifestations and duration of prednisone use were associated with plaque (P < 0.05), univariate analysis. Nephritis, immunosuppressive therapy, intravenous methylprednisolone and a higher average daily dose of prednisone were associated with the absence of plaque. Independent predictors of plaque were smoking (P = 0.004), LDL-c >100 mg/dL (P = 0.044), Framingham score (P = 0.006) and absence of immunosuppressive therapy (P = 0.032). There was an independent correlation between IMT and age (P < 0.001) and duration of prednisone use (P = 0.020). Subclinical atherosclerosis was associated with traditional risk and SLE-related factors, especially the absence of immunosuppressive therapy. The present study suggests that the levels of LDL-c should be kept under 100mg/dL in lupus.

MeSH terms

  • Adult
  • Atherosclerosis / diagnostic imaging*
  • Atherosclerosis / etiology*
  • Atherosclerosis / pathology
  • Brazil
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / etiology*
  • Carotid Artery Diseases / pathology
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / pathology
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / drug therapy
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Prednisone / therapeutic use
  • Risk Factors
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / pathology
  • Tunica Media / diagnostic imaging
  • Tunica Media / pathology
  • Ultrasonography

Substances

  • Cholesterol, LDL
  • Immunosuppressive Agents
  • Prednisone
  • Methylprednisolone