Subclinical atherosclerosis in Systemic Lupus Erythematosus: Comparable risk with Diabetes Mellitus and Rheumatoid Arthritis

Tektonidou, Maria G.; Kravvariti, Evrydiki; Konstantonis, George; Tentolouris, Nicholas; Sfikakis, Petros P.; Protogerou, Athanase D.

doi:10.1016/j.autrev.2017.01.009

Cited by 91 publications

(61 citation statements)

References 33 publications

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“…In line with the prevalence reported by other authors (2)(3)(4), about one third of our SLE patients presented carotid plaques, suggestive of subclinical atherosclerosis, even in the absence of a substantial cIMT increase. In fact, a significant arterial wall thickening was only detected in patients with CVD, whereas SLE patients without previous history of CV events have near 3-fold higher frequency of carotid plaques than controls after adjusting for traditional CV risk factors.…”

Section: Discussionsupporting

confidence: 93%

“…Recent evidence suggests an increased CV risk in patients at early disease stages or even at diagnosis. An increased prevalence of subclinical atherosclerosis, assessed by presence of carotid plaque and/or arterial wall thickening, has been observed in SLE patients (2)(3)(4). Moreover, subclinical atherosclerosis has been reported in young SLE patients without traditional risk factors (5).…”

Section: Introductionmentioning

confidence: 99%

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Clinical and subclinical cardiovascular disease in female SLE patients: Interplay between body mass index and bone mineral density

Rodríguez‐Carrio

Martínez-Zapico

Cabezas-Rodríguez

et al. 2019

Nutrition, Metabolism and Cardiovascular Diseases

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Background and aims: since accelerated atherosclerosis has been reported in systemic lupus erythematosus (SLE), predictive biomarkers of cardiovascular disease (CVD) are needed. Among non-traditional risk factors, bone mineral density (BMD) has been related to CVD. However, its role in SLE remains controversial. This study aims to analyze the associations of subclinical atherosclerosis with traditional and non-traditional CV risk factors. Methods and results: in a cross-sectional study, atherosclerosis burden was compared between 112 female SLE patients and 31 controls. Plaque number and carotid intima-media wall thickness (cIMT) were assessed by ultrasonography. In a retrospective study, BMD determinations obtained 5-years before the ultrasonography assessment were analyzed in a subgroup of 62 patients. Plaque frequency was increased in SLE, even in patients without CV events or carotid wall thickening. cIMT was increased in patients with CVD, positively correlated with body mass index (BMI). Interestingly, a paradoxical effect of BMI on carotid parameters was observed. Whereas underweight patients (BMI<20) showed increased prevalence of carotid plaques with low cIMT, those with BMI>30 showed higher cIMT and plaque burden. Overweight patients (25

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Clinical and subclinical cardiovascular disease in female SLE patients: Interplay between body mass index and bone mineral density

Rodríguez‐Carrio

Martínez-Zapico

Cabezas-Rodríguez

et al. 2019

Nutrition, Metabolism and Cardiovascular Diseases

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“…Infection and cardiovascular events are regarded as the most common causes of death in SLE. Cardiovascular diseases (CVD) are 5‐10 times more common in patients with SLE than in the general population . CVD in SLE occurs earlier than the general population and is affected by traditional risk factors such as obesity, diabetes, smoking and hypertension .…”

Section: Introductionmentioning

confidence: 99%

Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study

et al. 2019

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multiple organ involvement. 1 Since the strategies of treatment with glucocorticoids (GC) and immunosuppressive agents have been established, mortality risk has decreased in patients with SLE. 2 Infection and cardiovascular events are regarded as the most common causes of death in SLE. Cardiovascular diseases (CVD) are 5-10 times more common in patients with SLE than in the general population. 3-6 CVD in SLE occurs earlier than the general population and is affected by traditional risk factors such as obesity, diabetes, smoking and hypertension. 7,8 Disease Abstract Aim: Patients with systemic lupus erythematosus (SLE) have an increased risk of cardiovascular disease owing to an immunological abnormality, along with traditional risk factors. We found that carotid artery intima-media thickness (cIMT) and plaque were associated with age, body mass index (BMI) and disease activity in a previous study 4 years ago. Our aim was to identify risk factors associated with progression of subclinical atherosclerosis in SLE. Methods:We assessed cIMT and plaque using Doppler ultrasonography in 61 Korean women with SLE who were enrolled in the previous study 4 years ago. Results:The mean cIMT of the patients was 0.39 ± 0.09 mm; 11 patients had carotid plaques, which was similar to the results of the previous study. Twenty-one patients had increased cIMT, and new carotid plaque had developed in seven patients. Patients with increased cIMT had a lower BMI and took fewer non-steroidal anti-inflammatory drugs and higher 4 year cumulative glucocorticoid dose than patients without increased cIMT. The 4 year cumulative glucocorticoid dose was higher in patients with carotid plaque than in those without. On multivariate regression analysis, BMI (odds ratio [OR] = 0.67, P = 0.034) was associated with increased cIMT, and the 4 year cumulative glucocorticoid dose was associated with increased cIMT (OR = 6.994, P = 0.025) and carotid plaque (OR = 5.651, P = 0.031). Conclusion:This prospective follow-up study on cIMT and plaque in patients with SLE showed that low BMI and 4 year cumulative glucocorticoid dose were associated with the progression of subclinical atherosclerosis. K E Y W O R D S atherosclerosis, body mass index, carotid artery, disease activity, glucocorticoid, systemic lupus erythematosus | 1411 JUNG et al. activity, duration, specific manifestations or organ damage have been shown to increase the possibility of developing CVD. Dysfunctional immune and inflammatory response including the complement depletion, role of interferon, inflammatory cytokines and impaired endothelial function were revealed to contribute to the premature atherosclerosis development in patients with SLE. 9-12An assessment of the risk for CVD can be established using various methods, including carotid artery Doppler ultrasound, coronary artery calcium score and pulse wave velocity. Several studies assessing the risk of CVD in SLE have used different methods. 13,14 Carotid artery int...

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“…This endotype is most pronounced in chronic systemic inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, psoriasis, and ankylosing spondylitis. The severity and speed of atherosclerosis development in rheumatoid arthritis and systemic lupus erythematosus are similar to those in diabetes mellitus [76,77]. The relative risk of carotid plaque detection in patients with systemic lupus erythematosus is 2.4 times higher than in the general population, and the maximum risk (5.6 times) is observed in patients younger than 40 years old [78].…”

Section: Clinical Features and Comorbidmentioning

confidence: 83%

Conceptualization of Heterogeneity of Chronic Diseases and Atherosclerosis as a Pathway to Precision Medicine: Endophenotype, Endotype, and Residual Cardiovascular Risk

Генкель

Шапошник

2020

International Journal of Chronic Diseases

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The article discusses modern approaches to the conceptualization of pathogenetic heterogeneity in various branches of medical science. The concepts of endophenotype, endotype, and residual cardiovascular risk and the scope of their application in internal medicine and cardiology are considered. Based on the latest results of studies of the genetic architecture of atherosclerosis, five endotypes of atherosclerosis have been proposed. Each of the presented endotypes represents one or another pathophysiological mechanism of atherogenesis, having an established genetic substrate, a characteristic panel of biomarkers, and a number of clinical features. Clinical implications and perspectives for the study of endotypes of atherosclerosis are briefly reviewed.

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Subclinical atherosclerosis in Systemic Lupus Erythematosus: Comparable risk with Diabetes Mellitus and Rheumatoid Arthritis

Cited by 91 publications

References 33 publications

Clinical and subclinical cardiovascular disease in female SLE patients: Interplay between body mass index and bone mineral density

Clinical and subclinical cardiovascular disease in female SLE patients: Interplay between body mass index and bone mineral density

Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study

Conceptualization of Heterogeneity of Chronic Diseases and Atherosclerosis as a Pathway to Precision Medicine: Endophenotype, Endotype, and Residual Cardiovascular Risk

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