Contribution of traditional risk factors to coronary artery disease in patients with systemic lupus erythematosus

Objective, Several factors have been implicated in the high prevalence of p remature coronary artery disease (CAD) in patients with systemic lupus eryt hematosus (SLE). We hypothesize that variables independent of traditional r isk factors contribute significantly to the development of CAD in SLE. We i nvestigated the relative contribution of traditional risk factors in SLE pa tients with CAD compared to non-SLE patients with premature CAD. Methods. An age matched retrospective cohort analysis. The prevalence of tr aditional cardiovascular risk factors (hypertension, hypercholesterolemia, diabetes, smoking, family history) in patients with SLE who developed CAD d uring the course of their illness was compared to a group of age matched no n-SLE subjects with premature CAD. Sexes were analyzed separately using Fis her's exact test and unpaired t tests. Results. Thirty-five patients with SLE (27 women, 8 men) with definite isch emic heart disease were identified along with 397 non-SLE subjects (83 wome n, 314 men). In women with SLE the mean number of CAD risk factors per card iac event was 2.0 +/- 0.77 versus 2.90 +/- 1.19 for the comparison group (p = 0.0008). In men with SLE the mean number of CAD risk factors was 1.87 +/ - 0.83 versus 2.73 +/- 0.99 in the comparison group (p = 0.016). Conclusion, SLE patients with a cardiac event have fewer traditional risk f actors than non-SLE patients with premature CAD. Thus premature (CAD in SLE cannot be attributed solely to an excess of traditional risk factors.