Premature development and progression of atherosclerosis in systemic lupus erythematosus


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Abstract

Aim. Assessment of risk factors of premature atherosclerosis in patients with systemic lupus erythematosus (SLE). Methods. 70 patients with SLE (34 - with lupus nephritis) were included into the study. Atherosclerosis signs were detected by Duplex scanning of carotid arteries and multispiral computed tomography with coronary calcinosis assessment. Patients with chronic renal failure were excluded from the study. Results. atherosclerosis signs were detected in 36 (51%) patients in age 35 - 55 years (mean age 47,5±5,3 years). Monofactor analysis revealed age (<0,001), dyslipidemia (р=0,050), arterial hypertension (р=0,049), menopause (p=0,008), smoking (p=0,014), hyperfibrinogenemia (р=0,008), antiphospholipid syndrome (p=0,05) as risk factors for atherosclerosis. Atherosclerosis frequency increased in patients older than 40 years (61,1% vs 18,8%, р=0,004). Multifactor analysis demonstrated role of age, diastolic blood pressure in the period of disease manifestation, serum fibrinogen level as risk factors for atherosclerosis. SLE activity, measured by SLEDAI index, correlated with dyslipidemia (р=0,049), presence of antiphospholipid sundrome (р<0,001), lupus nephritis (р<0,001), steroid therapy (р<0,05). Conclusion. Premature development of atherosclerosis in systemic lupus erythematosis is associated with traditional and non-traditional risk factors: in high-risk patients screening for subclinical atherosclerosis signs is useful.

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