Document Detail


Duplex study of the carotid and femoral arteries of patients with systemic lupus erythematosus: a controlled study.
MedLine Citation:
PMID:  15124249     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify atherosclerosis in the common carotid (CCA) and common femoral arteries (CFA) of patients with systemic lupus erythematosus (SLE) and matched controls. METHODS: Fifty-one consecutive patients with SLE were enrolled in the study. Controls were matched by age, sex, ethnicity, and atherosclerosis risk factors. All patients and controls underwent ultrasonic biopsy (U-B) of the CFA and CCA, a noninvasive screening technique that detects early atherosclerotic plaques and changes. The U-B features were classified and scored as follows: class A: normal (score 0); class B: interface disruption (score 2); class C: intima-media granulation (score 4); class D: plaque without hemodynamic disturbance (score 6); class E: stenotic plaque (score 8); and class F: plaque with symptoms (score 10). Total score was calculated. Classes A and B indicate an intact media; classes D to F point to a significant medial involvement; class C signifies a borderline lesion with a potential for regression to normal or progression to a plaque. RESULTS: Mean ages were 40.5 years for SLE patients and 41 years for controls (p = 0.6). Ninety-six percent of the patients and controls were women. The mean disease duration of SLE was 8.65 years. Frequencies of risk factors among the SLE patients compared to controls were hypertension (30% vs 24%), smoking (23% vs 24%), and dyslipidemia (17.7% vs 17%). No patient had diabetes mellitus or family history of cardiovascular disease. A 3.17-fold increased rate of atherosclerotic plaques was detected in the SLE patients compared with controls (95% CI 1.08-10.9). Twenty-eight percent of SLE patients had at least a single class D-F lesion in one of the 4 vessels tested, compared with 10% in the control group (p = 0.02). In addition, the mean total U-B score of the SLE patients was significantly higher than that of the controls (5.65 vs 3.14; p = 0.02). Univariate analyses showed that the development of plaques in SLE was associated with a history of ischemic heart disease, hypertension, cardiovascular accident, and anemia. Multivariate analysis found plaques to be strongly associated with age, particularly in those older than 50 (OR 2.66, p = 0.000). CONCLUSION: Patients with SLE have a high rate of atherosclerotic changes compared to controls. The development of atherosclerosis is strongly associated with age.
Authors:
Talia Wolak; Evguenia Todosoui; Gabriel Szendro; Arkadi Bolotin; Bat-Sheva Jonathan; Daniel Flusser; Dan Buskila; Shaul Sukenik; Mahmoud Abu-Shakra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  31     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-04     Completed Date:  2004-08-09     Revised Date:  2005-09-13    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  909-14     Citation Subset:  IM    
Affiliation:
Rheumatic Diseases Unit, Soroka University Medical Center, Ben Gurion University, Beer-Sheva, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arteriosclerosis / etiology,  pathology*
Carotid Artery, Common / pathology*,  ultrasonography
Female
Femoral Artery / pathology*,  ultrasonography
Humans
Lupus Erythematosus, Systemic / complications,  pathology*,  physiopathology
Male
Risk Factors
Severity of Illness Index
Ultrasonography
Comments/Corrections
Comment In:
J Rheumatol. 2005 Jun;32(6):1171-2; author reply 1172-3   [PMID:  15940743 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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