Carotid intima-media thickness and plaque as surrogate biomarkers of atherosclerosis among consecutive women with systemic lupus erythematosus.

BACKGROUND: In recent years, there has been a growing interest in understanding the pathogenic pathways of premature accelerated atherosclerosis (AS) in systemic lupus erythematosus (SLE). However, the role of both traditional and non-traditional, SLE-specific risk factors is still under debate.

AIM: To assess surrogate biomarkers of subclinical AS in SLE and to evaluate potential relations with cardiovascular risk factors.

PATIENTS AND METHODS: Prospective observational study on 35 consecutive SLE women (ACR 1987 diagnostic criteria) evaluated according to a standard protocol including traditional cardiovascular risk factors (hypertension, obesity, diabetes mellitus, cigarette smoking, abnormal lipid metabolism), SLE-specific risk factors (renal disease, SLE activity and duration, corticosteroid therapy) and surrogate biomarkers of subclinical AS (carotid intima-media thickness, plaque) (B-mode color Doppler ultrasound, 7-10 MHz probe). Data were analyzed in SPSS 16 software, p<0.05.

RESULTS: Significant differences (p<0.05) among subgroups (with and without plaque, thickened and normal intima) have been registered; moreover, statistical significant correlations between cIMT and age (r=0.476), age at onset (r=0.451), VLDL (r=0.382), hsCRP (r=0.436), Framingham score (r=0.421) have been reported. In addition, significant association between homocysteine and SLE-duration (r=0.460), SLEDAI (r=0.466), SLICC÷ACR (r=0.846) has been demonstrated, while hsCRP was associated with ESR (r=0.472), C3 (r=0.396), SLEDAI (r=0.569) and age (r=-0.681). Several predictors for increased cIMT have also been identified (ANOVA): hsCRP (p=0.016), VLDL (p=0.037), Framingham (p=0.012).

CONCLUSIONS: Our data advocate for increased cardiovascular burden in SLE and support the value of cIMT and carotid plaque as surrogate AS biomarkers in women with SLE.