Risk factors for cardiovascular disease in systemic lupus erythematosus

Background-Cardiovascular disease (CVD) is overrepresented in patients with systemic lupus erythematosus (SLE). We determined the prevalence of tradit ional and nontraditional risk factors for CVD in SLE patients with and with out CVD compared with controls. Methods and Results-Twenty-six women (aged 52 +/-8.2 years) with SLE and a history of CVD (SLE cases) were compared with 26 age-matched women with SLE but without manifest CVD (SLE controls) and 26 age-matched population-base d control women (population controls). Common carotid intima-media thicknes s (IMT) was measured by B-mode ultrasound as a surrogate measure of atheros clerosis. SLE cases had increased IMT compared with SLE controls (P=0.03) a nd population controls (P=0.001), whereas IMT of SLE controls did not diffe r from population controls. SLE cases had raised plasma concentrations of c irculating oxidized LDL (OxLDL; P=0.03), as measured by the monoclonal anti body EO6, and autoantibodies to epitopes of OxLDL (P <0.001); dyslipidemia with raised triglycerides (P<0.001) and lipoprotein(a) (P=0.002) and decrea sed HDL-cholesterol concentrations (P=0.03); raised a-l-antitrypsin (P=0.00 2), lupus anticoagulant (P=0.007), and homocysteine levels (P=0.03); more f requent osteoporosis (P=0.03); and a higher cumulative prednisolone dose (P =0.05) compared with SLE controls. Disease duration, smoking, blood pressur e, body mass index, and diabetes mellitus did not differ significantly betw een the groups. Conclusions-A set of distinct CVD risk factors separate SLE cases from SLE controls and population controls. If confirmed in a prospective study, they could be used to identify SLE patients at high risk for CVD in order to op timize treatment.