Prevalence of Atherosclerotic Vascular Disease in Cuban Patients With Systemic Lupus Erythematosus

Estévez del Toro, Miguel; Chico Capote, Araceli; Barahona Jorge, Roque Alejandro; Jiménez Paneque, Rosa; Hernández Castro, Jorge

doi:10.1016/S2173-5743(08)70144-8

Article information

Atherosclerotic vascular disease-associated mortality and morbidity has increased in sick patients with systemic lupus erythematosus (SLE).

Objectives

To determine frequency of atherosclerotic vascular disease (AVD) in our patients, and to identify associations of some risk factors associated to its presence.

Method

Study included 51 patients and 51 controls paired by age, sex, and skin colour, who underwent carotid ultrasound (US) to measure thickness of the intima-medial complex, and to determine presence of plaques. In patients and controls we analyzed the presence of classic risk factors, eg, age, smoking, high blood pressure, diabetes mellitus, and hyperlipidemia. In addition in SLE we also analyzed the influencie on AVD of the clinical features of disease, as well as treatments applied.

Results

Risk factors were similar between patients and controls, except for hypertriglyceridemia, which was more frequent in patients. Presence of plaque was more prevalent in patients than in controls (59.9% vs 23.5%, P=.001). In multivariate analysis, age (OR, 1.31; 95% CI, 1.038–1.253; P=.005), diagnosis of SLE (OR, 3.872; 95% CI, 1.4–10.2; P=.005), and the presence of damage measured by SLICC/ACR (OR, 34.884; 95% CI, 1.1–12.9; P=.006) were the only variables independently associated to the presence of atherosclerosis in our patients.

Conclusions

Frequency of atherosclerosis is increased in patients presenting with SLE, risk factors independent of those classics, seem to be associated with this presence.

Key words:

Prevalence

Atherosclerotic vascular disease

Systemic lupus erythematosus

La morbimortalidad asociada a enfermedad vascular aterosclerótica ha aumentado en los enfermos con lupus eritematoso sistémico (LES).

Objetivos

Determinar la frecuencia con que se encuentra la enfermedad vascular aterosclerótica en nuestros pacientes, e identificar la asociación de algunos factores de riesgo con su presencia.

Método

El estudio incluyó a 51 pacientes y 51 controles identificados por edad, sexo y color de piel, a quienes se realizó ultrasonido de carótida para medir el grosor del complejo íntima-media y determinar la presencia de placa. Se identificaron, en pacientes y controles, los factores de riesgos clásicos, como edad, hábito tabáquico, hipertensión arterial, diabetes mellitus e hiperlipemia. En los pacientes con LES se analizaron además las características clínicas de la enfermedad y los tratamientos recibidos. Finalmente, se estudió la influencia de todas estas variables en la enfermedad vascular aterosclerótica de los pacientes con LES.

Resultados

Los factores de riesgo fueron similares entre pacientes y controles con la excepción de la hipertrigliceridemia más frecuente en los pacientes. La presencia de placa fue más prevalente en los pacientes que en los controles (el 56,9% frente al 23,5%, p=0,001). En el análisis multivariable, la edad (odds ratio [OR]=1,31; intervalo de confianza [IC] del 95%, 1,038–1,253; p=0,005), el diagnóstico de LES (OR=3,872; IC del 95%, 1,4–10,2; p=0,005) y el daño sistémico valorado por el índice de SLICC/ACR (OR=3,884; IC del 95%, 1,1–12,9; p=0,006) fueron las variables que de forma independiente se asociaron a la presencia de aterosclerosis en los pacientes con LES.

Conclusiones

La frecuencia de aterosclerosis se encuentra aumentada en los pacientes con LES, y parece que podría estar asociada a otros factores de riesgo independientes a los clásicamente implicados en la aterosclerosis.

Palabras clave:

Prevalencia

Aterosclerosis vascular

Lupus eritematoso sistémico

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