Article Text
PDF
Abstract
Lupus systemic erythematosus is characterised by an increasing risk of premature cardiovascular disease (CVD). CVD is one of the most common causes of death in SLE. Subclinical atherosclerosis in comparison to general population is also more prevalent.
Methods A cross-sectional study was carried out from March to November 2015. Patients (119; 94.1% women) were recruited from consultation at the Systemic Autoimmune Diseases Unit for a routine medical check.
The population was divided into three groups: patients with lupus free cardiovascular disease (free CVD), lupus with subclinic cardiovascular disease (sub CVD) (with endothelial dysfunction in ultrasonography but no clinic events) and people with clinical cardiovascular disease.
Patients with subclinical disease have higher cholesterol levels when compared to patients with established cardiovascular disease (p value=0.008) and to patients with SLE without vascular disease (p value=0.043). This is due to the lack of knowledge of subclinical damage by the clinician and, in addition to the absence of visible vascular damage, strict control of cholesterol levels is not performed in this group. Likewise, LDL cholesterol levels are elevated in the same context as triglycerides (differences between SLE free and SLE with subclinical SLE).
There were no differences in the activity index, what is likely to be in relation to the low activity they had at the time of inclusion in the study. We do have indeed detected differences in the time of evolution of those who present vascular damage (longer evolution time, 22.88 years) compared to patients without vascular involvement (12.32 years) suggesting that at the same time as more years of disease are accumulated vascular damage accumulates. Likewise patients with vascular damage and subclinical vascular damage were older (55.12 and 54.29, respectively), compared to those with no involvement (42.94 years).
No differences were detected between the use of antimalarials or the deleterious effect of corticosteroids and immunosuppressants (traditionally associated with increasing vascular risk) in the presence of clinical, subclinical or absence of vascular damage.
It is important to know the lupic population with a higher tendences to have vascular damage for the purpose of greater control.