title: Carotid atherosclerotic alterations in systemic lupus erythematosus patients treated at a Brazilian university setting.
abstract: To determine the frequency of carotid plaque and intima-media thickness (IMT) in patients with systemic lupus erythematosus (SLE) and their association with risk factors in a Brazilian university setting. Carotid plaque and IMT were identified and measured by ultrasonography. Traditional risk factors and lupus-related factors were analysed. One hundred and seventy-two patients (women = 96%, age = 38 +/- 11 years) were evaluated. The frequency of carotid plaque was 9.3%. The median (IR) IMT was 0.60 mm (0.54-0.71 mm). Age, family history (FH) of premature coronary disease, low-density cholesterol (LDL-c) >100 mg/dL, hypertriglyceridemia, diabetes, hypertension, smoking, postmenopause, number of risk factors, Framingham risk score, age at diagnosis, duration of lupus, mucocutaneous manifestations and duration of prednisone use were associated with plaque (P < 0.05), univariate analysis. Nephritis, immunosuppressive therapy, intravenous methylprednisolone and a higher average daily dose of prednisone were associated with the absence of plaque. Independent predictors of plaque were smoking (P = 0.004), LDL-c >100 mg/dL (P = 0.044), Framingham score (P = 0.006) and absence of immunosuppressive therapy (P = 0.032). There was an independent correlation between IMT and age (P < 0.001) and duration of prednisone use (P = 0.020). Subclinical atherosclerosis was associated with traditional risk and SLE-related factors, especially the absence of immunosuppressive therapy. The present study suggests that the levels of LDL-c should be kept under 100mg/dL in lupus.
authors.affiliation: Rheumatology Service of the Hospital das Clínicas, Locomotor System Department of the School of Medicine at the Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. rwtelles@ig.com.br, rwtelles@uol.com.br
authors.forename: R W
authors.initials: RW
authors.lastname: Telles
authors.forename: C C D
authors.initials: CC
authors.lastname: Lanna
authors.forename: G A
authors.initials: GA
authors.lastname: Ferreira
authors.forename: A J
authors.initials: AJ
authors.lastname: Souza
authors.forename: T P
authors.initials: TP
authors.lastname: Navarro
authors.forename: A L
authors.initials: AL
authors.lastname: Ribeiro
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D001938:Brazil; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
chemical_list: D008078:Cholesterol, LDL; D007166:Immunosuppressive Agents; D011241:Prednisone; D008775:Methylprednisolone