Document Detail


Premature aortic atherosclerosis in systemic lupus erythematosus: a controlled transesophageal echocardiographic study.
MedLine Citation:
PMID:  19955049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Premature carotid and coronary atherosclerosis are common in systemic lupus erythematosus (SLE), but data on aortic atherosclerosis (AA) are limited. Thus, using multiplane transesophageal echocardiography (TEE), we sought to determine the prevalence and clinical correlates of AA in patients with SLE.
METHODS: Forty-seven patients with SLE (44 women, age 38 +/- 12 years) and 21 healthy controls (19 women, age 34 +/- 12 years) underwent clinical and laboratory evaluations and TEE to assess AA defined as aortic intima media thickness (IMT) > 0.86 mm or plaques as > 50% focal IMT as compared with surrounding walls. TEE studies were interpreted by an experienced observer unaware of subjects' clinical data.
RESULTS: The prevalence of abnormal aortic IMT, plaques, or both lesions was higher in patients as compared to controls (37%, 23%, and 43% vs 14%, 0%, and 14%, respectively, all p </= 0.02). In patients, age at diagnosis of SLE was the only positive independent predictor of AA [OR 1.12 per year from diagnosis of SLE, 95% confidence interval (CI) 1.04-1.19, p = 0.001] and cyclophosphamide therapy was the only negative independent predictor of AA (OR 0.186, 95% CI 0.153-0.95, p = 0.04, equivalent to 5.4 times less likely to develop AA).
CONCLUSION: AA is common in young patients with SLE and is predicted by a later age at diagnosis of SLE, but is negatively correlated with cyclophosphamide therapy. Thus, early diagnosis and more aggressive immunosuppressive therapy may be required to decrease the development and progression of atherosclerosis in patients with SLE.
Authors:
Carlos A Roldan; Joseph Joson; Janeen Sharrar; Clifford R Qualls; Wilmer L Sibbitt
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-12-01
Journal Detail:
Title:  The Journal of rheumatology     Volume:  37     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-30     Completed Date:  2010-04-05     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  71-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Cardiology Division, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, New Mexico 87108, USA. croldan@salud.unm.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age of Onset
Aorta* / pathology,  ultrasonography
Atherosclerosis* / epidemiology,  pathology,  ultrasonography
Child
Disease Progression
Echocardiography, Transesophageal*
Female
Humans
Lupus Erythematosus, Systemic* / complications,  pathology,  ultrasonography
Middle Aged
Tunica Intima / pathology
Tunica Media / pathology
Young Adult
Grant Support
ID/Acronym/Agency:
R01 HL077422/HL/NHLBI NIH HHS; R01 HLO77422-01-A3//PHS HHS; UL1 TR000041/TR/NCATS NIH HHS
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