Assessment of premature coronary atherosclerosis in patients with systemic lupus erythematosus disease

IntroductionSystemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that affects mainly young women. The incidence of myocardial infarction is 5 times higher in SLE patients than in the general population.Aim of the workThe aim of our study was to assess the frequency and extent of coronary artery calcification as measured by multidetector computed tomography (CT) in SLE patients and to identify the associated variables.Patients and methodsThirty SLE patients and 30 matched healthy controls were included in the study. Patients were not known to have atherosclerosis. Patients and controls were subjected to full history taking, clinical examination, laboratory investigations including complete blood count, urine analysis, serum urea, creatinine, homocysteine, triglycerides, total cholesterol, high and low density lipoproteins. Multi detector CT study of the coronaries was performed.ResultsCoronary calcification was detected in 4 (13.3%) of the patients and none of the control. The homocysteine level was significantly higher in the patients (13.42 ± 5.33 μmol/L) compared to the control (9.39 ± 1.48 μmol/L) (p = 0.002). The calcium score was 42 ± 111.09 in the patients and zero in the control. The calcification score of the 4 patients was between 101 and 400. Patients with calcification had significantly higher cholesterol, triglycerides and homocysteine levels (p < 0.0001, p = 0.032 and p = 0.002, respectively). The calcium score significantly correlated with the serum cholesterol (r = 0.54, p = 0.002) and homocysteine level (r = 0.78, p = 0.001).ConclusionPremature coronary artery calcification is more common in SLE patients than in the general population. Subclinical atherosclerosis in SLE is associated with traditional risk factors like hypercholesterolemia and hypertriglyceridemia as well as increased homocysteine level.