Men with SLE at increased risk of coronary artery calcifications
Men with systemic lupus erythematosus (SLE) are more likely to develop coronary artery calcifications (CAC) than age- and sex-matched controls, a recent study has shown. Such risk among patients with SLE is associated with older age, increasing chronic damage and cumulative dose of corticosteroids.
CAC occurred more frequently in patients with SLE than in controls (18 percent vs 7 percent; odds ratio [OR], 2.89; 95 percent CI, 1.07–8.65). The following factors independently correlated with the presence of calcifications: age (OR, 1.12; 1.04–1.20), SLE diagnosis (OR, 3.38; 1.07–10.64), diabetes mellitus (OR, 6.88; 1.50–31.62), Framingham risk score (OR, 1.12; 1.00–1.23) and glomerular filtration rate (OR, 0.98; 0.96–1.00).
Patients with SLE presented with CAC starting at age 32 years, within 2.3 years of diagnosis. The following were independent risk factors for CAC: increasing age (OR, 1.18; 1.06–1.31), Systemic Lupus International Collaborating Clinics score (OR, 2.85; 1.21–6.73) and cumulative dose of prednisone (OR, 1.04; 1.01–1.08).
To determine whether the prevalence and extent of asymptomatic coronary artery atherosclerosis were increased in men with SLE vs controls, the investigators used multidetector computed tomography to screen 95 patients with SLE (mean age 34.7 years) and 100 control participants (mean age 34.8 years) with no history of coronary artery disease for CAC. The Agatston score was used to measure the extent of calcification.
The investigators compared the frequency of risk factors between patients and controls, and examined the relationship between clinical and immunological characteristics and the presence of CAC.