Abstract
Background Cardiovascular disease is a significant burden on SLE patients and no satisfactory markers exist to predict atherosclerotic development in patients. This study utilised an orthogonal approach to develop a marker of cardiovascular progression with predictive value in SLE patients.
Methods The earliest available sample from a cohort of 92 SLE patients was tested for anti-Domain I (aDI), anti Beta-2-Glycoprotein-I, and anti-Cardiolipin antibodies. Persistent positivity was not assessed. These patients then had vascular ultrasound scans (carotid and femoral arteries) (mean 10 years later) to assess subclinical atherosclerotic plaque. A range of demographic, clinical and serological markers were recorded at the time of the scan. Predictors of plaque presence were investigated using binary logistic regression.
Results A total of 34 patients from the cohort of 92 had atherosclerotic plaque (37%). A total of 32 patients had aDI positivity, of which 20 (62.5%) also had Plaque, this is reflected by the significantly higher levels of aDI antibodies seen in Plaque patients (p<0.01, figure 1). Anti-DI positivity was predictive of the development of plaque in the future (Odds Ratio (OR) 5.476, p <0.001). No association was seen for any other antibody tested. Multiple binary logistic regression showed aDI positivity had as much predictive value as triglyceride levels on the day of the scan (OR 3.5 vs 3.9, table 1) for predicting plaque in patients. Age at scan was a third independent variable associated with atherogenic plaque.
A significantly higher level of aDI antibody was seen in plaque patients in comparison to non-plaque patients.
Conclusions Early aDI positivity may be a good marker of atherogenesis in SLE patients in the long term.
