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

• Published in: Lupus Vol. 17; no. 2; pp. 105 - 113
• Main Authors: Telles, RW, Lanna, Ccd, Ferreira, GA, Souza, AJ, Navarro, TP, Ribeiro, AL
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2008; Sage Publications Ltd
• Subjects: Adult; Age; Atherosclerosis; Atherosclerosis - diagnostic imaging; Atherosclerosis - etiology; Atherosclerosis - pathology; Brazil; Cardiovascular disease; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - etiology; Carotid Artery Diseases - pathology; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - pathology; Cholesterol, LDL - blood; Coronary vessels; Cross-Sectional Studies; Female; Hospitals; Humans; Immunosuppressive Agents - therapeutic use; Lupus; Lupus Erythematosus, Systemic - blood; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - drug therapy; Male; Methylprednisolone - therapeutic use; Middle Aged; Mortality; Prednisone - therapeutic use; Rheumatology; Risk Factors; Tunica Intima - diagnostic imaging; Tunica Intima - pathology; Tunica Media - diagnostic imaging; Tunica Media - pathology; Ultrasonic imaging; Ultrasonography; Vein & artery diseases; Brazil; atherosclerosis; traditional risk factors for coronary artery disease; systemic lupus erythematosus; atherosclerotic plaque; carotid ultrasonography
• ISSN: 0961-2033; 1477-0962
• DOI: 10.1177/0961203307085312

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. Lupus (2008) 17, 105—113.