Noncalcified coronary plaque in systemic lupus erythematosus.
OBJECTIVE
To study noncalcified coronary plaque (NCP) in systemic lupus erythematosus (SLE).


METHODS
Sixty-four-slice coronary multidetector computed tomography (MDCT) was performed in 39 consecutive patients with SLE. MDCT scans were evaluated semiquantitatively by a radiologist using dedicated software. The presence or absence of NCP in each coronary artery was assessed. Patients with mixed plaque (calcified and noncalcified portions) were included in the NCP group.


RESULTS
The patient group was 90% women, 64% Caucasian, 31% African American, 5% other; mean age 50.5 +/- 9.6 years. Fifty-four percent (21/39) had NCP. Seventy-six percent (16/21) of those with NCP also had coronary calcium (range 0.7 to 1264.1 Agatston units). In univariate analysis, NCP was associated with age (p = 0.01), current nonsteroidal antiinflammatory drug (NSAID) use (p = 0.04), hormone replacement therapy (p = 0.02), current use of immunosuppressive drugs (p = 0.02), current low serum C3 level (p = 0.07), current physician's global assessment of activity (PGA; p = 0.05), and low-density lipoprotein cholesterol (p = 0.04). NCP was not associated with other risk factors for atherosclerosis, including total serum cholesterol, high sensitivity C-reactive protein, and lipoprotein(a).


CONCLUSIONS
Unlike coronary calcium, which is not associated with SLE activity measures or with active serologies, NCP is more common in patients with SLE with current, 3-, and 6-month activity by PGA. NCP was also associated with the need for current NSAID or immunosuppressive therapy. NCP is an important part of the total atherosclerotic burden in SLE.
Kiani
Adnan N
AN
Division of Rheumatology and Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Vogel-Claussen
Jens
J
Magder
Laurence S
LS
Petri
Michelle
M
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002118:Calcium / Q000378:metabolism*; D015331:Cohort Studies; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000378:metabolism*; D003331:Coronary Vessels / Q000378:metabolism*; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D036542:Tomography, Spiral Computed
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003176:Complement C3; D003181:Complement C4; D007166:Immunosuppressive Agents; D002118:Calcium