SLE - Practical and theoretical barriers to the prevention of accelerated atherosclerosis in systemic lupus erythematosus

Karen H Costenbader, Matthew H Liang, Karen H Costenbader, Matthew H Liang

Abstract

Accelerated atherosclerotic vascular disease (ASVD) is a major cause of death in systemic lupus erythematosus (SLE). Although many authorities are calling for aggressive assessment and management of cardiac risk factors in patients with SLE, both theoretical and practical barriers to this approach exist. It seems that SLE and/or its treatment are themselves strong risk factors for the development of ASVD and it is unclear how much this risk can be decreased by the control of traditional risk factors. Studies from several centers have shown that suboptimal risk factor management and barriers to acceptance of these measures must also be studied further.

References

    1. Urowitz MB, Bookman AAM, Koehler BE, Gordon DA, Smythe HA, Ogryzlo MA. The bimodal mortality pattern of systemic lupus erythematosus. Am J Med. 1976;60:221–225.
    1. Manzi S, Meilahn EN, Rairie JE, Conte CG, Medsger TA, Jr, Jansen-McWilliams L, D'Agostino RB, Kuller LH. Age-specific incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham Study. Am J Epidemiol. 1997;145:408–415.
    1. Badui E, Garcia-Rubi D, Robles E, Jimenez J, Juan L, Deleze M, Diaz A, Mintz G. Cardiovascular manifestations in systemic lupus erythematosus. Prospective study of 100 patients. Angiology. 1985;36:431–441.
    1. Bruce IN, Burns RJ, Gladman DD, Urowitz MB. High prevalence of myocardial perfusion abnormalities in women with SLE [abstract] Arthritis Rheum. 1997;40(suppl):S219.
    1. Bulkley BH, Roberts WC. The heart in systemic lupus erythematosus and the changes induced in it by corticosteroid therapy. A study of 36 necropsy patients. Am J Med. 1975;58:243–264.
    1. Kong TQ, Kellum RE, Haserick JR. Clinical diagnosis of cardiac involvement in systemic lupus erythematosus: a correlation of clinical and autopsy findings in thirty patients. Circulation. 1962;26:7–11.
    1. Hosenpud JD, Montanaro A, Hart MV, Haines JE, Specht HD, Bennett RM, Kloster FE. Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus. Am J Med. 1984;77:286–292.
    1. Shome GP, Sakauchi M, Yamane K, Takemura H, Kashiwagi H. Ischemic heart disease in systemic lupus erythematosus. A retrospective study of 65 patients treated with prednisolone. Jpn J Med. 1989;28:599–603.
    1. Haider YS, Roberts WC. Coronary arterial disease in systemic lupus erythematosus; quantification of degrees of narrowing in 22 necropsy patients (21 women) aged 16 to 37 years. Am J Med. 1981;70:775–781.
    1. Manzi S, Selzer F, Sutton-Tyrrell K, Fitzgerald SG, Rairie JE, Tracy RP, Kuller LH. Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus. Arthritis Rheum. 1999;42:51–60. doi: 10.1002/1529-0131(199901)42:1<51::AID-ANR7>;2-D.
    1. Salmon JE, Roman MJ. Accelerated atherosclerosis in systemic lupus erythematosus: implications for patient management. Curr Opin Rheumatol. 2001;13:341–344. doi: 10.1097/00002281-200109000-00001.
    1. Aranow C, Ginzler EM. Coronary artery disease in SLE: high suspicion leads to early recognition. J Musculoskel Med. 2000;17:473–482.
    1. Bruce IN, Gladman DD, Urowitz MB. Detection and modification of risk factors for coronary artery disease in patients with systemic lupus erythematosus: a quality improvement study. Clin Exp Rheumatol. 1998;16:435–440.
    1. Hallegua DS, Wallace DJ. How accelerated atherosclerosis in SLE has changed our management of the disorder. Lupus. 2000;9:228–231.
    1. Lockshin MD, Salmon JE, Roman MJ. Atherosclerosis and lupus: a work in progress. Arthritis Rheum. 2001;44:2215–2217. doi: 10.1002/1529-0131(200110)44:10<2215::AID-ART381>;2-F.
    1. Giri S, Parke AL, Waters DD. Controlling cardiovascular risk factors in systemic lupus erythematosus. J Musculoskel Med. 1998;15:42–52.
    1. El-Magadmi M, Ahmad Y, Wajed J, Bruce IN. The bimodal mortality pattern in systemic lupus erythematosus. Curr Med Lit Rheumatol. 2003;22:1–6.
    1. Esdaile JM, Abrahamowicz M, Grodzicky T, Li Y, Panaritis C, du Berger R, Cote R, Grover SA, Fortin PR, Clarke AE, Senecal JL. Traditional Framingham risk factors fail to fully account for accelerated atherosclerosis in systemic lupus erythematosus. Arthritis Rheum. 2001;44:2331–2337. doi: 10.1002/1529-0131(200110)44:10<2331::AID-ART395>;2-I.
    1. Petri M, Spence D, Bone LR, Hochberg MC. Coronary artery disease risk factors in the Johns Hopkins Lupus Cohort: prevalence, recognition by patients, and preventive practices. Medicine (Baltimore) 1992;71:291–302.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera