Background Premature atherosclerosis has been recognized as a major cause of morbidity and mortality in SLE patients. Whether the effect of risk factors for cardiovascular disease in patients with lupus change over time is still unknown. We aimed to identify the incidence and risk factors for progression of coronary-artery calcification (CAC) in SLE patients.
Methods Design: Inception Cohort. Since enrollment into the cohort, all patients had a standardized medical history, physical examination, and laboratory tests, including lipid profile, apoB, homocystein, high-sensitivity C-reactive protein (hs-CRP), serum complement (C3 and C4), and autoantibodies. Every 3–6 months, patients have been seen at the lupus clinic for medical care, and assessments of disease activity using the SLE disease activity scores, and medications usage. Every year, information has been updated, including irreversible damage accrual, any co-morbidities, traditional cardiovascular risk-factors, and a blood sample has been drawn. In 2008, 104 lupus patients from the cohort (93% females) was screened for coronary-artery calcifications using Multidetector Computed Tomography, after 5.1 years of follow-up. In 2018 a follow-up screening for CAC was carried-up. CAC was considered as positive if i) patients without CAC in 2008 were found with CAC +in the second screening or ii) patients with CAC positive in 2008 were found with any increase of their Calcium Score. Correlates for calcifications were analyzed. Cumulative incidence of CAC was calculated and risk factors for CAC progression were identified by multivariate analysis.
Results At-enrollment into de cohort, lupus patients were 27.2+9.1 years of age and disease duration 5.4+3.8 months. On 2008 during the first screening, coronary-artery calcification were detected in 7.2% patients, since age 23 years, and from three years of diagnosis. At follow-up screening, progression of CAC was identified in 16.3% (IC95% 10.4–24.6). Cumulative incidence of CAC was observed in 9%. Earlier Risk factors associated with CAC were disease activity (p=0.03) and disease duration (p=0.03) while risk factors for progression of CAC were postmenopausal status (p=0.01), apoB levels (p=0.01).
Conclusions Our findings suggest that in patients with SLE earlier CAC is associated with disease severity while in the progression of CAC, traditional risk factors for atherosclerosis were adding.
Funding Source(s): None
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