title: Prognostic role of coronary calcification in patients with rheumatoid arthritis and systemic lupus erythematosus.
abstract: OBJECTIVE
  To study the predictive value of coronary calcification score (CCS) for future cardiovascular (CVS) events as detected by multi-detector computed tomography (MDCT) in patients with rheumatoid arthritis(RA) and systemic lupus erythematosus (SLE).
  
  
  METHODS
  A total of 152 patients with RA and SLE, and 106 healthy controls underwent MDCT to measure CCS. All patients were prospectively followed up for major CVS events.
  
  
  RESULTS
  Compared with controls, patients with RA and SLE had a significantly higher mean CCS (42.2±154.3 vs. 1.4±13.0, p<0.01) and prevalence of CCS 1-10, CCS 11-100 and CCS>100 (all p<0.05). After a mean period of 4.3±0.6 years, major CVS events occurred in 10 patients with RA and SLE. In patients with RA and SLE, a higher major CVS events rate occurred in patients with CCS 1-10 (5.0%), CCS 11-100 (14.3%) and CCS >100 (40.0%) than those with CCS=0 (1.0%, p<0.01). Multivariate Cox regression analysis revealed that hypercholesterolemia (hazard ratio (HR) 11.2, confidence interval (CI 1.4-89.3, p=0.02) and CCS>100 (HR 11.1, CI 1.31-95.0, p=0.03) were independent predictors of combined events.
  
  
  CONCLUSIONS
  Coronary calcification detected by MDCT independently predicts CVS events in patients with RA and SLE. Risk stratification by assessment of CCS may have an important role in patients with systemic inflammatory disease.
authors.affiliation: Department of Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong. khkyiu@hotmail.com
authors.forename: K H
authors.initials: KH
authors.lastname: Yiu
authors.forename: M Y
authors.initials: MY
authors.lastname: Mok
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.forename: G C
authors.initials: GC
authors.lastname: Ooi
authors.forename: P L
authors.initials: PL
authors.lastname: Khong
authors.forename: C S
authors.initials: CS
authors.lastname: Lau
authors.forename: H F
authors.initials: HF
authors.lastname: Tse
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D057791:Cardiac Imaging Techniques; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed