Longitudinal study on premature atherosclerosis in patients with systemic lupus erythematosus

Atherosclerosis. 2009 Oct;206(2):546-50. doi: 10.1016/j.atherosclerosis.2009.03.018. Epub 2009 Mar 25.


Objectives: To determine risk factors of accelerated atherosclerosis and progression of intima-media thickness (IMT) in patients with systemic lupus erythematosus (SLE).

Methods: 74 SLE patients, age ranging from 13 to 69 years, and 74 age- and sex-matched controls were included. IMT of the common carotid artery was determined by B-mode ultrasound imaging. Traditional risk factors for atherosclerosis and disease-related factors were recorded. Cardiovascular risk was estimated using systematic coronary risk evaluation (SCORE). Markers of inflammation (C-reactive protein, CRP) and endothelial activation (thrombomodulin, vascular cell adhesion molecule-1, and von Willebrand factor) were determined. Measurements were repeated in 52 patients after a follow-up of 32+/-7 months.

Results: IMT was increased in SLE patients compared to controls. Prevalence of smoking and hypertension, use of lipid-lowering drugs and SCORE were higher in patients, as well as levels of CRP and markers of endothelial activation. The age-related increase in IMT was significantly higher in patients than in controls. In multivariate analysis, age and disease duration was independently related to IMT. Increase in IMT during follow-up was related to age only.

Conclusion: The age-related increase in IMT is higher in SLE, indicating that atherosclerosis is accelerated in SLE patients. This is mainly due to disease-related risk factors, as disease duration was independently associated with IMT.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Atherosclerosis / etiology*
  • C-Reactive Protein / metabolism
  • Endothelium, Vascular / diagnostic imaging
  • Female
  • Humans
  • Longitudinal Studies
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnostic imaging
  • Lupus Erythematosus, Systemic / pathology
  • Male
  • Middle Aged
  • Risk Factors
  • Thrombomodulin / blood
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / pathology
  • Tunica Media / diagnostic imaging
  • Tunica Media / pathology
  • Ultrasonography
  • Vascular Cell Adhesion Molecule-1 / blood


  • Thrombomodulin
  • Vascular Cell Adhesion Molecule-1
  • C-Reactive Protein