Background Cardiovascular diseases are the main cause of morbidity and mortality in SLE patients. Detection of risk factors can increase survival and improve quality of life.
Objectives The aim of study was the detection of subclinical atherosclerosis measured by ultrasound evaluation of intima media thickness and its correlatation to PVW (pulse velocity wave), traditional risk factor, and clinical profile of the disease, autoantibodies and selected laboratory markers.
Methods From March 2015 to January 2016 we examined 42 patients with SLE (5 men, 37 women) by ultrasound of carotic arteries. Traditional risk factors, clinical manifestation, immunological profile and disease activity scores (SELENA-SLEDAI 2K, SLICC) were collected. Cumulative dose of glucocorticosteroids and duration of disease was calculated. History of cardiovascular events was recorded. Statistical tests (descriptive statistic, Student t-test, Spearman test, ANOVA) were performed, p-value ≤0.05 was considered as significant.
Results Pathological IMT was detected in 10 patients (23.8%). IMT correlated with cumulative dose of glucocorticoids, levels of anti ds DNA (p=0.05), low levels of C3 (p=0.03), positivity of LA and high LSR (p=0.007,p=0.05), low levels of GF and serum creatinine (p=0.03, p=0.04), anti La antibodies (p=0.009), leucopenia (p=0.007), haematological manifestation (p=0.04), dyslipidemia (p=0.03) and PVW (p=0.01). The presence of plaques correlated with BMI (p=0.05), cardiac failure (p=0.03), anti ds DNA (p=0.03), LA (p=0.003), low levels of HDL (p=0.005), hsCRP (p=0.05), PWV (p=0.04). If groups with or without pathological IMT were compared, there was difference in age (p≤0.001), smoking - packet-years (p=0.01), cardial failure (p=0.02), stroke and lupus CNS (p=0.02, resp. 0.003), cardiac manifestation (p=0.003) and hrCRP (p=0.02). There was no correlation in lipid profile. In this group 5 strokes, 5 cardiac failure, 2 myocardial infarction, 4 ischemic heart disease and 6 cardiac manifestation were present.
Conclusions IMT and detection of plaques are very important markers of subclinical atherosclerosis. They correlated with traditional risk factors and are good prognostic factor of cardiovascular and ischemic CNS manifestation. It is important to evaluated both IMT and plaques. The result of the study highlights the necessity of active screening of cardiac involvement in SLE patients.
Acknowledgement Grant support: MZ CR VES15–28659A
Disclosure of Interest None declared