[High cardiovascular complications in systemic lupus erythematosus: physiopathology and risk management].
Today, cardiovascular mortality is the first cause of mortality in systemic lupus erythematosus (SLE). A 40-year-old woman with SLE is over 50 times more likely to have a myocardial infraction than a healthy woman of similar age. The high CV risk has a double origin: an early and progressive atherosclerosis and a prothrombotic propensity. Multiple factors are incriminated, including a higher prevalence of traditional CV risk factors in SLE population, as well as SLE-specific factors. Autoantibodies can modify lipid profile, induce tissue factor synthesis, favour clotting and endothelial apoptosis. Moreover, endothelial dysfunction and permanent chronic inflammation are present. Treatments are occasionally involved. To reduce more efficiently CV risk in SLE patients, we propose to consider SLE has a complete CV risk factor that should be implemented for CV risk management. This medical procedure of CV risk estimation is unusual in young patients. Its implementation in SLE patients requires a modification of medical practices. CV risk management in SLE patients include identification of optimal targets for each traditional risk factor and SLE specific treatments.
Boffa
Jean-Jacques
JJ
Service de néphrologie et dialyses, hôpital Tenon, AP-HP, Paris, France. jean-jacques.boffa@tnn.aphp.fr
Rougier
Jean-Philippe
JP
Noël
Nicolas
N
Ronco
Pierre
P
D050197:Atherosclerosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D012307:Risk Factors; D012308:Risk Management