Article Text
Abstract
Background Cardiovascular disease (CVD) is the leading cause of late death in patients with systemic lupus erythematosus (SLE). SLE is related with up to 50 fold risk of CVD. SLE is recognised as an independent cardiovascular risk factor (CVR). However, traditional scales underestimates the CVR in SLE.
Objectives Determine the correlation between traditional CVR scores (Framingham, systematic coronary risk evaluation (SCORE), arteriosclerotic cardiovascular disease (ASCVD) and arterial stiffness (AS) in an open population of SLE, assessing AS by pulse wave velocity (PWV), vascular damage through cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), quality intima media thickness (qIMT) and SLE disease activity using the systemic lupus erythematosus disease activity index (SLEDAI) and systemic lupus international collaborating clinics (SLICC).
Methods Patients with SLE of 18 years old and older, diagnosed according to SLICC 2012 criteria. Informed written consent. AS was determined by PWV, CAVI, ABI, and qIMT. Disease activity was recorded by SLEDAI and SLICC. Comparison between qualitative variables will be done through the X2 test or the Fisher exact test. For comparison of the quantitative variables with normal distribution Student’s T and ANOVA tests were done. The correlation coefficient (r) of Pearson was calculated. Variables with a p≤0.2 value were included in a multiple linear regression model to evaluate the influence of the disease variables on CVR. SPSS v.22 software (IBM, inc) and the Graphpad V software were used.
Results The total of SLE patient were 44 (100%), with a mean age of 34±12 years old. Thirty six women (82%). The mean evolution time was 6±5 years. Smoke was registered in 16% (7 cases). Systolic blood pressure 110±14, diastolic blood pressure 73±11 mmHg. Body mass index 28.4±9.1, total cholesterol 186±47, triglycerides 143±67, cHDL 42.9±5.1, cLDL 57±27 mg/dL. Erythrocyte sedimentation rate of 17±14 mm/hr, cReactive protein 7.1±4.8 mg/L. Anti.dsDNA antibodies were present in 47.7% of the cases.21 Secondary antiphospholipid syndrome in 13.6%.6 Mean SLEDAI 8 (range 0–32), mean SLICC 1 (range 0–6). C3 levels 83.6±21.4, C4 19.5±18.8 mg/dL. The most important correlations found were with qIMT and age 0.651 (<0.001), BMI 0.513 (p 0.001), cRp 0.351 (0.033), cLDL 0.400 (0.01). Framingham score was able to predict CVR up to 44.8% the measurement of PWV, ASCVD in 30% and SCORE up to 22%.
Conclusions Traditional scores (Framingham, SCORE, ASCVD) underestimate cardiovascular risk in patients with SLE. The most important finding is that qIMT was able to correlate more than age, to BMI and cLDL in SLE patients.
Disclosure of Interest None declared