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Progression of carotid intima-media thickness and plaque in women with systemic lupus erythematosus.
Arthritis Rheum 2008; 58(3):835-42AR

Abstract

OBJECTIVE

Women with systemic lupus erythematosus (SLE) are at high risk of cardiovascular disease (CVD). The goals of this study were to determine the extent of atherosclerotic progression among women with SLE compared with a group of healthy controls and to determine whether factors attributed to SLE or its treatment were associated with atherosclerotic progression independent of traditional CVD risk factors.

METHODS

A longitudinal study of women with SLE from the Pittsburgh Lupus Registry was conducted. Women 18 years of age and older (n = 217) underwent carotid ultrasound at baseline and at followup, an average of 4.19 years later. Clinical, serologic, and SLE-related factors, and disease treatment were evaluated. Outcomes were changes in carotid intima-media thickness (IMT) and plaque. Progression of CVD in a sample of women without lupus was used for comparison.

RESULTS

The patients' mean +/- SD age at baseline was 45.1 +/- 10.3 years, and the mean +/- SD IMT progression rate was 0.011 +/- 0.03 mm per year. After controlling for traditional CVD risk factors, higher serum creatinine levels were associated with IMT progression (P = 0.0006). Plaque prevalence was 31% at baseline and 40% at followup; plaque progression occurred in 27% of the patients. Higher serum C3 levels and immunosuppressant use at baseline were related to plaque progression (P = 0.04 and P = 0.02, respectively) independent of traditional CVD risk factors. The plaque progression rate was higher than, and the IMT progression rate was similar to, those in the control group.

CONCLUSION

SLE patients have accelerated plaque progression compared with controls. SLE-related risk factors are associated with the progression of IMT and plaque after controlling for traditional CVD risk factors. Carotid B-mode ultrasound may serve as a surrogate end point in SLE intervention trials and clinically to track SLE management.

Authors+Show Affiliations

University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18311797

Citation

Thompson, Trina, et al. "Progression of Carotid Intima-media Thickness and Plaque in Women With Systemic Lupus Erythematosus." Arthritis and Rheumatism, vol. 58, no. 3, 2008, pp. 835-42.
Thompson T, Sutton-Tyrrell K, Wildman RP, et al. Progression of carotid intima-media thickness and plaque in women with systemic lupus erythematosus. Arthritis Rheum. 2008;58(3):835-42.
Thompson, T., Sutton-Tyrrell, K., Wildman, R. P., Kao, A., Fitzgerald, S. G., Shook, B., ... Manzi, S. (2008). Progression of carotid intima-media thickness and plaque in women with systemic lupus erythematosus. Arthritis and Rheumatism, 58(3), pp. 835-42. doi:10.1002/art.23196.
Thompson T, et al. Progression of Carotid Intima-media Thickness and Plaque in Women With Systemic Lupus Erythematosus. Arthritis Rheum. 2008;58(3):835-42. PubMed PMID: 18311797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progression of carotid intima-media thickness and plaque in women with systemic lupus erythematosus. AU - Thompson,Trina, AU - Sutton-Tyrrell,Kim, AU - Wildman,Rachel P, AU - Kao,Amy, AU - Fitzgerald,Shirley G, AU - Shook,Betsy, AU - Tracy,Russell P, AU - Kuller,Lewis H, AU - Brockwell,Sarah, AU - Manzi,Susan, PY - 2008/3/4/pubmed PY - 2008/4/29/medline PY - 2008/3/4/entrez SP - 835 EP - 42 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 58 IS - 3 N2 - OBJECTIVE: Women with systemic lupus erythematosus (SLE) are at high risk of cardiovascular disease (CVD). The goals of this study were to determine the extent of atherosclerotic progression among women with SLE compared with a group of healthy controls and to determine whether factors attributed to SLE or its treatment were associated with atherosclerotic progression independent of traditional CVD risk factors. METHODS: A longitudinal study of women with SLE from the Pittsburgh Lupus Registry was conducted. Women 18 years of age and older (n = 217) underwent carotid ultrasound at baseline and at followup, an average of 4.19 years later. Clinical, serologic, and SLE-related factors, and disease treatment were evaluated. Outcomes were changes in carotid intima-media thickness (IMT) and plaque. Progression of CVD in a sample of women without lupus was used for comparison. RESULTS: The patients' mean +/- SD age at baseline was 45.1 +/- 10.3 years, and the mean +/- SD IMT progression rate was 0.011 +/- 0.03 mm per year. After controlling for traditional CVD risk factors, higher serum creatinine levels were associated with IMT progression (P = 0.0006). Plaque prevalence was 31% at baseline and 40% at followup; plaque progression occurred in 27% of the patients. Higher serum C3 levels and immunosuppressant use at baseline were related to plaque progression (P = 0.04 and P = 0.02, respectively) independent of traditional CVD risk factors. The plaque progression rate was higher than, and the IMT progression rate was similar to, those in the control group. CONCLUSION: SLE patients have accelerated plaque progression compared with controls. SLE-related risk factors are associated with the progression of IMT and plaque after controlling for traditional CVD risk factors. Carotid B-mode ultrasound may serve as a surrogate end point in SLE intervention trials and clinically to track SLE management. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/18311797/Progression_of_carotid_intima_media_thickness_and_plaque_in_women_with_systemic_lupus_erythematosus_ L2 - https://doi.org/10.1002/art.23196 DB - PRIME DP - Unbound Medicine ER -