Early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patients
Objective: To elucidate early coronary atherosclerotic changes in premenopausal systemic lupus erythematosus (SLE) female patients without clinical cardiovascular manifestation using a 64-slice Multi-detector computed tomography (MDCT) scan to detect coronary calcification and measure coronary calci...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2013-12-01
|
| Series: | The Egyptian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1110260812001445 |
| _version_ | 1811206894808727552 |
|---|---|
| author | Khaled Mohamed Said Othman Naglaa Youssef Assaf |
| author_facet | Khaled Mohamed Said Othman Naglaa Youssef Assaf |
| author_sort | Khaled Mohamed Said Othman |
| collection | DOAJ |
| description | Objective: To elucidate early coronary atherosclerotic changes in premenopausal systemic lupus erythematosus (SLE) female patients without clinical cardiovascular manifestation using a 64-slice Multi-detector computed tomography (MDCT) scan to detect coronary calcification and measure coronary calcium score (CCS), and to find out its correlation to some traditional and non-traditional risk factors.
Methodology: Sixty consecutive premenopausal SLE female patients, and sixty age and sex matched healthy subjects without known systemic, immunological, or cardiovascular disease (served as a control group) underwent clinical examination, serological analysis, and 64-slice MDCT-based coronary calcium scoring. All the clinical, serological, and MDCT parameters of the patients were correlated.
Results: Coronary calcification (CC) was seen in 21 patients (35%), the number of atherosclerotic calcified plaques ranged from 0 to 19. Calcium scores ranged from 0 to 843. In contrast to control subjects, SLE patients had significantly higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), total cholesterol level, low-density lipoprotein (LDL), immunoglobulin G (IgG) and IgM anti-cardiolipin antibodies, serum intracellular adhesion molecule (sICAM) and E-selectin levels. SLE patients had highly significantly more atherosclerotic plaques (3 ± 0.66 compared to 0.1 ± 0.07, p < 0.001) and higher CCS (59.2 ± 20.3 compared to 2.6 ± 1.85, p < 0.001). Significant positive correlation was found between both number of atherosclerotic plaques and CCS and total cholesterol level, LDL, cumulative prednisone dose, SLE disease activity index (SLEDAI), ESR, CRP, sICAM-1, E-Selectin, and anti-cardiolipin antibodies (p < 0.05 in all).
Conclusion: Pre-menopausal SLE female patients free from clinical atherosclerotic vascular disease have an increased number of atherosclerotic plaques and CCS, which correlate positively with SLEDAI disease activity score, serum CRP, anticardiolipin antibodies, sICAM-1, E-Selectin, LDL level, total cholesterol level, and cumulative prednisone dose. In addition, we conclude that MDCT is a non-invasive, sensitive, reproducible, and reliable tool for accurate measurement of coronary calcification. |
| first_indexed | 2024-04-12T03:54:43Z |
| format | Article |
| id | doaj.art-0ff0f8c417c04c40b674ac5c238b6ead |
| institution | Directory Open Access Journal |
| issn | 1110-2608 |
| language | English |
| last_indexed | 2024-04-12T03:54:43Z |
| publishDate | 2013-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-0ff0f8c417c04c40b674ac5c238b6ead2022-12-22T03:48:51ZengSpringerOpenThe Egyptian Heart Journal1110-26082013-12-0165428128810.1016/j.ehj.2012.12.003Early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patientsKhaled Mohamed Said Othman0Naglaa Youssef Assaf1Department of Cardiology, Ain Shams University, Faculty of Medicine, EgyptDepartment of Physical Medicine, Rheumatology & Rehabilitation, Ain Shams University, Faculty of Medicine, EgyptObjective: To elucidate early coronary atherosclerotic changes in premenopausal systemic lupus erythematosus (SLE) female patients without clinical cardiovascular manifestation using a 64-slice Multi-detector computed tomography (MDCT) scan to detect coronary calcification and measure coronary calcium score (CCS), and to find out its correlation to some traditional and non-traditional risk factors. Methodology: Sixty consecutive premenopausal SLE female patients, and sixty age and sex matched healthy subjects without known systemic, immunological, or cardiovascular disease (served as a control group) underwent clinical examination, serological analysis, and 64-slice MDCT-based coronary calcium scoring. All the clinical, serological, and MDCT parameters of the patients were correlated. Results: Coronary calcification (CC) was seen in 21 patients (35%), the number of atherosclerotic calcified plaques ranged from 0 to 19. Calcium scores ranged from 0 to 843. In contrast to control subjects, SLE patients had significantly higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), total cholesterol level, low-density lipoprotein (LDL), immunoglobulin G (IgG) and IgM anti-cardiolipin antibodies, serum intracellular adhesion molecule (sICAM) and E-selectin levels. SLE patients had highly significantly more atherosclerotic plaques (3 ± 0.66 compared to 0.1 ± 0.07, p < 0.001) and higher CCS (59.2 ± 20.3 compared to 2.6 ± 1.85, p < 0.001). Significant positive correlation was found between both number of atherosclerotic plaques and CCS and total cholesterol level, LDL, cumulative prednisone dose, SLE disease activity index (SLEDAI), ESR, CRP, sICAM-1, E-Selectin, and anti-cardiolipin antibodies (p < 0.05 in all). Conclusion: Pre-menopausal SLE female patients free from clinical atherosclerotic vascular disease have an increased number of atherosclerotic plaques and CCS, which correlate positively with SLEDAI disease activity score, serum CRP, anticardiolipin antibodies, sICAM-1, E-Selectin, LDL level, total cholesterol level, and cumulative prednisone dose. In addition, we conclude that MDCT is a non-invasive, sensitive, reproducible, and reliable tool for accurate measurement of coronary calcification.http://www.sciencedirect.com/science/article/pii/S1110260812001445Coronary calcificationCalcium scoreAtherosclerosisSLE |
| spellingShingle | Khaled Mohamed Said Othman Naglaa Youssef Assaf Early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patients The Egyptian Heart Journal Coronary calcification Calcium score Atherosclerosis SLE |
| title | Early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patients |
| title_full | Early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patients |
| title_fullStr | Early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patients |
| title_full_unstemmed | Early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patients |
| title_short | Early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patients |
| title_sort | early detection of premature subclinical coronary atherosclerosis in systemic lupus erythematosus patients |
| topic | Coronary calcification Calcium score Atherosclerosis SLE |
| url | http://www.sciencedirect.com/science/article/pii/S1110260812001445 |
| work_keys_str_mv | AT khaledmohamedsaidothman earlydetectionofprematuresubclinicalcoronaryatherosclerosisinsystemiclupuserythematosuspatients AT naglaayoussefassaf earlydetectionofprematuresubclinicalcoronaryatherosclerosisinsystemiclupuserythematosuspatients |