title: Risk factors in the progression of subclinical atherosclerosis in women with systemic lupus erythematosus.
abstract: OBJECTIVE
  To investigate risk factors in subclinical atherosclerosis progression as measured by coronary artery calcium (CAC) and aorta calcium (AC) in women with systemic lupus erythematosus (SLE; cases) and in comparison with a control population.
  
  
  METHODS
  A cohort of 149 cases and 124 controls participated in the Study of Lupus Vascular and Bone Long-Term Endpoints. Demographic information, cardiovascular and SLE risk factors, and laboratory assessments were collected at an initial visit. CAC and AC were measured by electron beam computed tomography (CT) or multidetector CT at an initial visit and at a followup visit. Logistic regression models were used to identify predictors of progression in CAC and AC; multivariate models were adjusted for age, hypertension, and total cholesterol to high-density lipoprotein ratio.
  
  
  RESULTS
  Higher modified Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) score (odds ratio [OR] 2.15, 95% confidence interval [95% CI] 1.33-3.57), use of a corticosteroid (OR 2.93, 95% CI 1.14-7.86), and use of aspirin (OR 4.23, 95% CI 1.53-11.74) were associated with CAC progression in multivariate models. Presence of SLE (OR 2.64, 95% CI 1.26-5.72), lower C3 (OR 0.54, 95% CI 0.33-0.87), lower C4 (OR 0.49, 95% CI 0.27-0.86), use of a corticosteroid (OR 2.73, 95% CI 1.03-7.64), higher corticosteroid dose (OR 1.77, 95% CI 1.12-3.00), higher lipoprotein(a) (OR 1.80, 95% CI 1.11-2.98), and higher homocysteine (OR 2.06, 95% CI 1.06-4.29) were associated with AC progression in multivariate models.
  
  
  CONCLUSIONS
  Higher disease damage at the first study visit, as measured by the modified SDI, may predict increased risk in CAC progression, whereas higher disease activity at the first study visit, as measured by hypocomplementemia and use of corticosteroids, may predict increased risk in AC progression.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Apinya
authors.initials: A
authors.lastname: Lertratanakul
authors.forename: Peggy
authors.initials: P
authors.lastname: Wu
authors.forename: Alan R
authors.initials: AR
authors.lastname: Dyer
authors.forename: George
authors.initials: G
authors.lastname: Kondos
authors.forename: Daniel
authors.initials: D
authors.lastname: Edmundowicz
authors.forename: James
authors.initials: J
authors.lastname: Carr
authors.forename: Rosalind
authors.initials: R
authors.lastname: Ramsey-Goldman
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000150:complications / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D012307:Risk Factors