title: Coronary calcification in SLE: comparison with the Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  Accelerated atherosclerosis is a major cause of morbidity and death in SLE. The purpose of this study was to determine whether the prevalence and extent of coronary artery calcium (CAC) is higher in female SLE patients compared with a non-SLE sample from the Multi-Ethnic Study of Atherosclerosis (MESA).
  
  
  METHODS
  CAC was measured in 80 female SLE patients and 241 female MESA controls from the Baltimore Field Centre, ages 45-64 years, without evidence of clinical cardiovascular disease. Binary regression was used to estimate the ratio of CAC prevalence in SLE vs MESA controls, controlling for demographic and cardiovascular risk factors. To compare the groups with respect to the quantity of CAC among those with non-zero Agatston scores, we used linear models in which the outcome was a log-transformed Agatston score.
  
  
  RESULTS
  The prevalence of CAC was substantially higher in SLE. The differences were most pronounced and statistically significant in those aged 45-54 years (58% vs 20%, P < 0.0001), but were still observed among those aged 55-65 years (57% vs 36%, P = 0.069). After controlling for age, ethnicity, education, income, diabetes mellitus, hypertension, hyperlipidaemia, high-density lipoprotein levels, smoking, education and BMI, SLE patients still had a significantly higher prevalence of CAC than controls. Among those with CAC, the mean log Agatston score did not differ significantly between SLE and MESA participants.
  
  
  CONCLUSIONS
  Women with SLE have a higher prevalence of CAC than comparable women without SLE, even after adjusting for traditional cardiovascular risk factors, especially among those aged 45-54 years.
authors.affiliation: Department of Medicine, Division of Rheumatology, Johns Hopkins University.
authors.forename: Adnan N
authors.initials: AN
authors.lastname: Kiani
authors.affiliation: Department of Epidemiology and Preventive Medicine, University of Maryland.
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Magder
authors.affiliation: Department of Medicine, Division of Rheumatology, Johns Hopkins University.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.affiliation: Department of Epidemiology, School of Medicine and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.affiliation: Department of Medicine, Division of Rheumatology, Johns Hopkins University.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Bathon
authors.affiliation: Department of Epidemiology, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN and.
authors.forename: Pam J
authors.initials: PJ
authors.lastname: Schreiner
authors.affiliation: Department of Medicine, Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: O'Leary
authors.affiliation: Department of Medicine, Division of Rheumatology, Johns Hopkins University, mpetri@jhmi.edu.
authors.forename: Michelle
authors.initials: M
authors.lastname: Petri
mesh_terms: D001741:Black or African American; D000367:Age Factors; D050197:Atherosclerosis / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology*; D002114:Calcinosis / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology*; D002118:Calcium / Q000032:analysis; D016022:Case-Control Studies; D003331:Coronary Vessels / Q000737:chemistry / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D036542:Tomography, Spiral Computed; D044465:White People
chemical_list: D002118:Calcium
keywords: Agatston score; MESA; atherosclerosis; cardiovascular; cohort; computed tomography; coronary artery calcium; inflammation; statins; systemic lupus erythematosus