PURPOSE: Premature coronary artery disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). The relationship between higher arterial stiffness and presence of atherosclerosis in patients with SLE independent of conventional risk factors is unclear. The purpose of the study was to determine the relationship between anatomic and functional markers of subclinical atherosclerosis including arterial stiffness and carotid intimal medial thickness in patients with SLE.
METHODS: We studied 60 female patients with the mean age of 43.5 ± 15.3 yrs. Arterial stiffness was evaluated by measuring augmentation index (AIx), and pulse wave velocity (PWV) by applanation tonometry. Carotid intimal-medial thickness (CIMT) was measured in common carotid via vascular ultrasound.
RESULTS: Mean AIx, CIMT, and PWV were 23.9 ± 13.8%, 0.57 ± 0.12 mm and 9.1 ± 1.5 m/sec respectively. Age was directly correlated with AIx (r=0.37, p=0.004) and CIMT (r=0.55, p=<.001). There was a significant correlation between AIx and CIMT (r=0.31, p=0.01). AIx was also correlated with PWV (r=0.44, p<.001). The duration of SLE disease was significantly correlated with higher AIx (r=0.44, p=0.001). Serum complement 3 and 4 levels were correlated with higher CIMT (p=0.02 and p=0.03). On multivariate analysis after adjusting for CV risk factors, AIx was independently correlated with age (p=.04, R2=0.21) but not with the severity of atherosclerosis.SLE patients without CV risk factors have higher AIx when compared to age and height matched normal healthy females (18.6 ± 11.3 vs. 9.8 ± 13%, p=0.01).
CONCLUSION: Arterial stiffness is increased in women with SLE even in the absence of CV risk factors. Anatomic and functional markers of subclinical atherosclerosis increase with the age but are unrelated.
CLINICAL IMPLICATIONS: Factor other than atherosclerosis may be responsible for higher arterial stiffness in women with lupus.
DISCLOSURE: Ghazanfar Qureshi, No Financial Disclosure Information; No Product/Research Disclosure Information