Premature atherosclerosis in systemic lupus erythematosus

SLE is associated with at least a Live-ford increased risk of coronary arte ry disease (CAD), and appears to abolish a female's premenopausal protectio n against CAD. Sub-clinical disease can be identified in up to 40% of patie nts. The pathogenesis of atherosclerosis in this context appears to be a co mplex interaction of factors associated with the disease, its therapy, and traditional risk factors. Hypercholesterolemia is predictive of future CAD events. In addition, SLE itself appears to be a strong risk factor for CAD over and above the effect of the known traditional CAD risk factors. An agg ressive approach to management of traditional CAD risk factors in patients with SLE is likely to have a major impact on morbidity and mortality in thi s population. Therefore, patients must be educated about this issue. Clinic ians that care for patients with SLE also need to assume a primary role in screening and coordinating the management of CAD risk factors in these high -risk patients.