C-reactive protein and coronary artery calcium in asymptomatic women with systemic lupus erythematosus or rheumatoid arthritis.
Patients with systemic lupus erythematosus (SLE) and those with rheumatoid arthritis (RA) have increased risk for atherosclerotic cardiovascular disease. The aims of this study were to compare the presence of coronary artery calcium (CAC) in age- and race-matched women with SLE, those with RA, and healthy controls without diabetes mellitus or history of myocardial infarction, angina pectoris, or stroke and to investigate its relation with traditional risk factors, inflammation, and endothelial activation. Study subjects completed cardiovascular risk factor assessment and electron-beam computed tomography that measured CAC. The 2 patient groups had similar prevalence and extent of CAC as well as significantly increased odds of having any CAC (odds ratio 1.87, 95% confidence interval 1.09 to 3.21) and more extensive CAC (odds ratio 4.04, 95% confidence interval 1.42 to 11.56 for CAC score >100) compared with healthy controls. After controlling for differences in cardiovascular risk factors, including insulin resistance and hypertension, the results remained statistically significant. After adjustment for differences in levels of C-reactive protein and/or soluble intercellular adhesion molecule-1, however, women with chronic inflammatory diseases no longer had significantly increased odds of having any CAC or more extensive CAC compared with controls. In conclusion, asymptomatic and nondiabetic women with chronic inflammatory diseases had significantly increased odds of having CAC and more extensive CAC compared with age- and race-matched healthy controls. The increased odds for CAC may in part result from higher levels of inflammation and endothelial activation in these patients.
Kao
Amy H
AH
Department of Medicine, Division of Rheumatology and Clinical Immunology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. ahk7@pitt.edu
Wasko
Mary Chester M
MC
Krishnaswami
Shanthi
S
Wagner
Joseph
J
Edmundowicz
Daniel
D
Shaw
Penny
P
Cunningham
Amy Lynn
AL
Danchenko
Natalya
N
Sutton-Tyrrell
Kim
K
Tracy
Russell P
RP
Kuller
Lewis H
LH
Manzi
Susan
S
D001172:Arthritis, Rheumatoid / Q000097:blood / Q000453:epidemiology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016022:Case-Control Studies; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D014057:Tomography, X-Ray Computed
D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein
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