Background Cardiovascular disease (CVD) is the main cause of death in systemic lupus erythematous (SLE) patients. Framingham score underestimates the risk for CVD in this population.
Objectives Our study aimed to determine whether serum High Sensitivity Cardiac Troponin T (HS-cTnT) helps to identify SLE patients at risk for CVD.
Methods Presence of carotid plaques was prospectively assessed by ultrasound in 63 consecutive SLE patients asymptomatic for CVD and 18 controls. Serum HS-cTnT concentration was measured using the electrochemiluminescence method. Factors associated with carotid plaques were identified and multivariate analysis was performed
Results Framingham score was low in both SLE patients (2.1±3.8%) and controls (2.1±2.9%). Nevertheless, 23 (36.5%) SLE patients, but only 2 (11.1%) controls (p=0.039), had carotid plaque detected by vascular ultrasound. In the multivariate analysis, only age (p=0.006) and SLE status (p=0.017) were independently associated with carotid plaques. Serum HS-cTnT concentration was detectable (i.e. >3 ng/L) in 37 (58.7%) SLE patients and 6 (33.3%) controls (p=0.057). Interestingly, 87% of SLE patients with carotid plaques, but only 42.5% in SLE patients without plaques (p<0.001), had a detectable HS-cTnT. Conversely, 54.5% SLE patients with a detectable HS-cTnT, but only 11.5% with an undetectable HS-cTnT (p<0.001), had a carotid plaque. In the multivariate analysis, only BMI (p=0.006) and HS-cTnT (p=0.033) were statistically associated with carotid plaques in SLE patients. Overall, the risk of having a carotid plaque was increased by 8 (OR [95% CI]: 8.03 [1.41–74.73]) in SLE patients in whom HS-cTnT was detectable in serum.
Conclusions Detectable HS-cTnT concentration is independently associated with subclinical atherosclerosis in asymptomatic SLE patients at apparent low risk for CVD according to traditional risk factors. These results raise the possibility that this easily obtained biomarker is useful for more rigorous risk stratification and primary prevention of CVD in SLE patients.
Disclosure of Interest None declared