Atherosclerosis and systemic lupus erythematosus.
The description of late-stage mortality and morbidity has been an important contribution to the understanding of systemic lupus erythematosus (SLE) in the past decade. Among the major factors in this clinical spectrum of SLE is the development of accelerated atherosclerosis. This condition has been recognized clinically with the documentation of myocardial infarction and angina in young women with SLE. This accelerated atherosclerosis has also been recognized at postmortem examinations. The exact mechanism for accelerated atherosclerosis remains unclear. However, disease activity with its immunologic events, the anticardiolipin syndrome, and the effect of corticosteroids in promoting hyperlipidemia contribute to its development. It appears that SLE may be a risk factor, in addition to the usual risk factors for the development of atherosclerosis. It has recently been shown that antimalarials may prevent some of the hyperlipidemia caused by corticosteroids. As evidence for the presence of subclinical atherosclerosis in these patients is accumulating, earlier diagnosis and treatment of events may be possible, and preventive measures may be instituted earlier.
Urowitz
M
M
University of Toronto, Director Centre of Prognosis Studies in The Rheumatic Diseases and The University of Toronto Lupus Clinic, The Toronto Hospital, Western Division, 399 Bathurst Street, 1-318, Toronto, Ontario, M5T 2S8, Canada. urowitz@utoronto.ca
Gladman
D
D
Bruce
I
I
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000962:Antimalarials / Q000008:administration & dosage; D001161:Arteriosclerosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate
D000305:Adrenal Cortex Hormones; D000962:Antimalarials