OBJECTIVE: A major cause of morbidity and mortality in systemic lupus erythematosus (SLE) is accelerated coronary atherosclerosis. New technology (computed tomographic angiography) can measure noncalcified coronary plaque (NCP), which is more prone to rupture. We report on a study of semiquantified NCP in SLE. METHODS: Patients with SLE (n = 147) with no history of cardiovascular disease underwent 64-slice coronary multidetector computed tomography (MDCT). The MDCT scans were evaluated quantitatively by a radiologist, using dedicated software. RESULTS: The group of 147 patients with SLE was 86% female, 70% white, 29% African American, and 3% other ethnicity. The mean age was 51 years. In our univariate analysis, the major traditional cardiovascular risk factors associated with noncalcified plaque were age (p = 0.007), obesity (p = 0.03; measured as body mass index), homocysteine (p = 0.05), and hypertension (p = 0.04). Anticardiolipin (p = 0.026; but not lupus anticoagulant) and anti-dsDNA (p = 0.03) were associated with higher noncalcified plaque. Prednisone and hydroxychloroquine therapy had no effect, but methotrexate (MTX) use was associated with higher noncalcified plaque (p = 0.0001). In the best multivariate model, age, current MTX use, and history of anti-dsDNA remained significant. CONCLUSION: Our results suggest that serologic SLE (anti-dsDNA) and traditional cardiovascular risk factors contribute to semiquantified noncalcified plaque in SLE. The association with MTX is not understood, but should be replicated in larger studies and in multiple centers.
OBJECTIVE: A major cause of morbidity and mortality in systemic lupus erythematosus (SLE) is accelerated coronary atherosclerosis. New technology (computed tomographic angiography) can measure noncalcified coronary plaque (NCP), which is more prone to rupture. We report on a study of semiquantified NCP in SLE. METHODS:Patients with SLE (n = 147) with no history of cardiovascular disease underwent 64-slice coronary multidetector computed tomography (MDCT). The MDCT scans were evaluated quantitatively by a radiologist, using dedicated software. RESULTS: The group of 147 patients with SLE was 86% female, 70% white, 29% African American, and 3% other ethnicity. The mean age was 51 years. In our univariate analysis, the major traditional cardiovascular risk factors associated with noncalcified plaque were age (p = 0.007), obesity (p = 0.03; measured as body mass index), homocysteine (p = 0.05), and hypertension (p = 0.04). Anticardiolipin (p = 0.026; but not lupus anticoagulant) and anti-dsDNA (p = 0.03) were associated with higher noncalcified plaque. Prednisone and hydroxychloroquine therapy had no effect, but methotrexate (MTX) use was associated with higher noncalcified plaque (p = 0.0001). In the best multivariate model, age, current MTX use, and history of anti-dsDNA remained significant. CONCLUSION: Our results suggest that serologic SLE (anti-dsDNA) and traditional cardiovascular risk factors contribute to semiquantified noncalcified plaque in SLE. The association with MTX is not understood, but should be replicated in larger studies and in multiple centers.
Authors: Andreas H Mahnken; Joachim E Wildberger; Ralf Koos; Rolf W Günther Journal: Cardiovasc Intervent Radiol Date: 2005 Jul-Aug Impact factor: 2.740
Authors: Michelle Petri; Mimi Y Kim; Kenneth C Kalunian; Jennifer Grossman; Bevra H Hahn; Lisa R Sammaritano; Michael Lockshin; Joan T Merrill; H Michael Belmont; Anca D Askanase; W Joseph McCune; Michelene Hearth-Holmes; Mary Anne Dooley; Joan Von Feldt; Alan Friedman; Mark Tan; John Davis; Mary Cronin; Betty Diamond; Meggan Mackay; Lisa Sigler; Michael Fillius; Ann Rupel; Frederick Licciardi; Jill P Buyon Journal: N Engl J Med Date: 2005-12-15 Impact factor: 91.245
Authors: Afshin Farzaneh-Far; Mary J Roman; Michael D Lockshin; Richard B Devereux; Stephen A Paget; Mary K Crow; Adrienne Davis; Lisa Sammaritano; Daniel M Levine; Jane E Salmon Journal: Arthritis Rheum Date: 2006-12
Authors: Eva Lonn; Salim Yusuf; Malcolm J Arnold; Patrick Sheridan; Janice Pogue; Mary Micks; Matthew J McQueen; Jeffrey Probstfield; George Fodor; Claes Held; Jacques Genest Journal: N Engl J Med Date: 2006-03-12 Impact factor: 91.245
Authors: Kaare Harald Bønaa; Inger Njølstad; Per Magne Ueland; Henrik Schirmer; Aage Tverdal; Terje Steigen; Harald Wang; Jan Erik Nordrehaug; Egil Arnesen; Knut Rasmussen Journal: N Engl J Med Date: 2006-03-12 Impact factor: 91.245
Authors: Yu Asanuma; Cecilia P Chung; Annette Oeser; Ayumi Shintani; Eran Stanley; Paolo Raggi; C Michael Stein Journal: J Rheumatol Date: 2006-02-01 Impact factor: 4.666