Inflammatory, Serological and Vascular Determinants of Cardiovascular Disease in Systemic Lupus Erythematosus Patients

Abstract

Background and aim: Systemic lupus erythematosus (SLE) is associated with increased risk of cardiovascular disease (CVD). Among many mechanisms, accelerated atherosclerosis, endothelial dysfunction, and hypercoagulability play a main role. Here, we investigate whether inflammatory, serological and clinical markers of SLE determine and correlate with arterial stiffness in SLE patients. Materials and methods: Routine blood samples, inflammatory mediators, specific antibodies, and 24 h proteinuria were measured in 43 SLE patients and 43 age and sex-matched controls using routine laboratory assays. We also assessed arterial stiffness by measuring radial artery applanation tonometry-derived augmentation index (AI), normalized AI (AIx@75), aortic pulse pressure, central systolic, diastolic and peripheral blood pressure. Results: SLE patients showed a significantly greater arterial stiffness vs. controls, as demonstrated by the significantly higher AIx@75 and aortic pulse pressure. Interestingly, regression analysis showed that age, systolic pulse pressure, inflammatory markers (erythrocyte sedimentation rate and C-reactive protein), daily dose of glucocorticoids, and cumulative organ damage positively correlated with arterial stiffness. Conclusions: SLE patients show increased arterial stiffness which correlates with markers of inflammation, that is involved in early alterations in arterial walls. Applanation tonometry can be used to screen SLE patients for subclinical vascular damage to implement prevention strategies for CVD.

Inflammation and Cardiovascular Diseases: The Most Recent Findings

“…The special issue, entitled “Mechanisms of inflammation in degenerative cardiovascular conditions”, presents 14 contributions that highlight the recent advances in the mechanisms of inflammation in cardiovascular diseases. In particular, these studies sustain the proof of concept that inflammation represents a significant cardiovascular risk factor [2,3,4,5] and is also mandatory to the development of both cardiac [2,3,5,6,7,8,9,10,11] and vascular events [4,12,13,14,15], and can be targeted using specific and non-specific therapeutics [8].…”

“…Moreover, inflammatory markers (i.e., PCR levels) predict a worse survival during acute coronary syndromes [2]. Accordingly, cardiovascular risk increases in patients with chronic inflammatory diseases such as rheumatoid arthritis [2], systemic lupus erythematosus [4], periodontitis [3], and atopic dermatitis [5]. Mercurio and colleagues showed that in patients with lupus erythematosus the increased arterial stiffness significantly correlates with several markers of inflammation [4].…”

Ankle-Brachial Index in Systemic Lupus Erythematosus: A Senegalese Case-Control Study

“…Accelerated atherosclerosis in SLE has been related to traditional risk factors and some SLE related factors such as disease duration, steroid therapy, activity, organ damage [5] [8] [9] [10]. In previous studies, the major determinants of low ABI were age and smoking.…”

“…Traditional cardiovascular factors (including Diabetes mellitus, hypertension, tobacco, atherogenic dyslipidemia), SLE therapies such as corticosteroid and disease-related factors (subclinical inflammation, oxidative stress, antiphospholipid antibodies) appear to contribute to the increasing of incidence of cardiovascular events in SLE [5] [8] [9] [10].…”

Cross-Sectional Analysis of the Association between Periodontitis and Cardiovascular Disease Using the Korean Genome and Epidemiology Study Data

“…The balance between the stability and instability of the atherosclerotic plaque induced by cellular apoptosis, secretion of matrix metalloproteases, and severe inflammation determines the fate of the plaque and the risk of sudden events. Various chronic infectious (e.g., periodontitis) and inflammatory diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus, and psoriasis) are significant risk factors for cardiovascular events [11,12].…”