title: Peripheral vascular disease in systemic lupus patients.
abstract: BACKGROUND
  Systemic lupus erythematosus (SLE) is an independent risk factor for cardiovascular disease (CVD). Ankle-brachial index (ABI) is a measure of peripheral vascular disease (PVD), low values of which are associated with CVD.
  
  
  OBJECTIVE
  Objectives were to identify the prevalence of PVD in SLE, to identify risk factors associated with PVD in SLE, and to determine whether SLE is an independent risk factor for PVD as assessed by ABI.
  
  
  METHODS
  In a cross-sectional analysis of SLE subjects and control subjects, free of known CVD, SLE-related variables and cardiovascular risk factors were measured. Peripheral vascular disease was assessed using ABI. The prevalence of PVD (ABI ≤ 1.0) and comparisons of mean ABI, between SLE and control subjects, were examined. Systemic lupus erythematosus was examined as an independent risk for PVD in the cohort using propensity score matching. Logistic regression was performed to identify independent risk factors for PVD in SLE.
  
  
  RESULTS
  Ankle-brachial index was lower in the 134 SLE subjects compared with 77 control subjects: 1.05 versus 1.09 (P = 0.003), and the prevalence of PVD was higher in SLE than in control subjects (33% vs 20%; P = 0.037). Systemic lupus erythematosus was not an independent risk for PVD. In the SLE subjects, the only significant risk factor for PVD was smoking.
  
  
  CONCLUSIONS
  Ankle-brachial index, a marker of subclinical CVD, is an inexpensive and easy method in which to assess PVD. There was a 33% prevalence of PVD in SLE, which was independently associated with smoking. As PVD is a coronary artery disease risk equivalent, screening and diagnosis may change lipid management in preventive cardiovascular risk assessment in patients with SLE. The combination of SLE and a smoking history may identify individuals for whom checking an ABI makes particular sense.
authors.affiliation: From the *Division of Rheumatology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh; and †Division of Rheumatology, Departments of Medicine and Pediatrics, Pennsylvania State University/Milton S. Hershey Medical Center, Hershey, PA.
authors.forename: Rayford R
authors.initials: RR
authors.lastname: June
authors.forename: Lisabeth V
authors.initials: LV
authors.lastname: Scalzi
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors