High-risk coronary plaque in SLE: low-attenuation non-calcified coronary plaque and positive remodelling index
Background Positive remodelling index and presence of low-attenuation non-calcified plaque (LANCP) are characteristic vessel changes in unstable coronary plaques. We sought to characterise these high-risk plaque features in patients with systemic lupus erythematosus (SLE) and to compare them with co...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-12-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/7/1/e000409.full |
| _version_ | 1818655987883573248 |
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| author | Michelle A Petri Armin Arbab-Zadeh Jessica Li George Stojan Matthew Budoff |
| author_facet | Michelle A Petri Armin Arbab-Zadeh Jessica Li George Stojan Matthew Budoff |
| author_sort | Michelle A Petri |
| collection | DOAJ |
| description | Background Positive remodelling index and presence of low-attenuation non-calcified plaque (LANCP) are characteristic vessel changes in unstable coronary plaques. We sought to characterise these high-risk plaque features in patients with systemic lupus erythematosus (SLE) and to compare them with controls.Methods A total of 72 patients who satisfied the SLICC classification criteria for SLE had coronary CT angiography (CCTA) studies, 30 of which had follow-up CCTA, as screening for occult coronary atherosclerotic disease in asymptomatic individuals. A total of 100 consecutive controls with no known history of lupus, heart disease or revascularisation who had two coronary CT angiograms at least 1 year apart were included in the study. These were asymptomatic patients referred by their primary physicians for screening of coronary artery disease and the screening interval was decided by the primary physicians. The methodology for image acquisition was identical.Results LANCP burden at baseline was significantly greater in patients with SLE compared with controls. LANCP volume was significantly greater in patients over 60 years of age (p<0.05) and in those with current prednisone dose >10 mg/day. LANCP burden remained stable over follow-up. There were no significant differences in remodelling index compared with controls.Conclusion This is the first study describing high-risk CCTA features of coronary plaque in patients with SLE. Both LANCP and positive remodelling are common in SLE. These characteristic vessel changes may identify patients with SLE at increased risk of cardiovascular events and those in need for more frequent cardiac monitoring. |
| first_indexed | 2024-12-17T03:18:26Z |
| format | Article |
| id | doaj.art-c1974dd1276b4993a8a5e0d24309bd82 |
| institution | Directory Open Access Journal |
| issn | 2053-8790 |
| language | English |
| last_indexed | 2024-12-17T03:18:26Z |
| publishDate | 2020-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj.art-c1974dd1276b4993a8a5e0d24309bd822022-12-21T22:05:35ZengBMJ Publishing GroupLupus Science and Medicine2053-87902020-12-017110.1136/lupus-2020-000409High-risk coronary plaque in SLE: low-attenuation non-calcified coronary plaque and positive remodelling indexMichelle A Petri0Armin Arbab-Zadeh1Jessica Li2George Stojan3Matthew Budoff4Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USACardiology, Johns Hopkins University, Baltimore, Maryland, USARheumatology, Johns Hopkins University, Baltimore, Maryland, USARheumatology, Johns Hopkins University, Baltimore, Maryland, USACardiology, David Geffen School of Medicine, Los Angeles, California, USABackground Positive remodelling index and presence of low-attenuation non-calcified plaque (LANCP) are characteristic vessel changes in unstable coronary plaques. We sought to characterise these high-risk plaque features in patients with systemic lupus erythematosus (SLE) and to compare them with controls.Methods A total of 72 patients who satisfied the SLICC classification criteria for SLE had coronary CT angiography (CCTA) studies, 30 of which had follow-up CCTA, as screening for occult coronary atherosclerotic disease in asymptomatic individuals. A total of 100 consecutive controls with no known history of lupus, heart disease or revascularisation who had two coronary CT angiograms at least 1 year apart were included in the study. These were asymptomatic patients referred by their primary physicians for screening of coronary artery disease and the screening interval was decided by the primary physicians. The methodology for image acquisition was identical.Results LANCP burden at baseline was significantly greater in patients with SLE compared with controls. LANCP volume was significantly greater in patients over 60 years of age (p<0.05) and in those with current prednisone dose >10 mg/day. LANCP burden remained stable over follow-up. There were no significant differences in remodelling index compared with controls.Conclusion This is the first study describing high-risk CCTA features of coronary plaque in patients with SLE. Both LANCP and positive remodelling are common in SLE. These characteristic vessel changes may identify patients with SLE at increased risk of cardiovascular events and those in need for more frequent cardiac monitoring.https://lupus.bmj.com/content/7/1/e000409.full |
| spellingShingle | Michelle A Petri Armin Arbab-Zadeh Jessica Li George Stojan Matthew Budoff High-risk coronary plaque in SLE: low-attenuation non-calcified coronary plaque and positive remodelling index Lupus Science and Medicine |
| title | High-risk coronary plaque in SLE: low-attenuation non-calcified coronary plaque and positive remodelling index |
| title_full | High-risk coronary plaque in SLE: low-attenuation non-calcified coronary plaque and positive remodelling index |
| title_fullStr | High-risk coronary plaque in SLE: low-attenuation non-calcified coronary plaque and positive remodelling index |
| title_full_unstemmed | High-risk coronary plaque in SLE: low-attenuation non-calcified coronary plaque and positive remodelling index |
| title_short | High-risk coronary plaque in SLE: low-attenuation non-calcified coronary plaque and positive remodelling index |
| title_sort | high risk coronary plaque in sle low attenuation non calcified coronary plaque and positive remodelling index |
| url | https://lupus.bmj.com/content/7/1/e000409.full |
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