Subclinical atherosclerosis is associated with future cardiovascular events in lupus patients at apparent low cardiovascular risk.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-06-01 Epub Date: 2025-05-15 DOI:10.1177/09612033251344200
Arthur Mageau, Florence Arnoult, Marie-Paule Chauveheid, Thomas Papo, Karim Sacre
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Abstract

ObjectivesPrediction models based on traditional risk factors underestimate the risk for cardiovascular events (CVE) in SLE. We aimed to assess the occurrence of CVE in SLE patients according to their baseline subclinical atherosclerosis status.MethodsCarotid intima-media thickness at the carotid bulb level (CIMT) was prospectively assessed in consecutive SLE patients followed in our national reference center for rare diseases by a single evaluator, between February 2012 and February 2013. SLE patients with known CVE were excluded. CIMT >1.5 mm defined carotid plaque as a measure of subclinical atherosclerosis. The main outcome was a CVE defined as the occurrence during follow-up of myocardial infarction, ischemic stroke or symptomatic peripheral arterial disease.Results63 SLE patients (82.5% female, median age 39 [32-44.5]) were included. Among them, 24 (38.1%) had a carotid plaque >1.5 mm at baseline and 7 (11.1%) experienced a cardiovascular event during a median follow-up of 10.7 [8.2-11.0] years. All CVE occurred in the group of patients who had a carotid plaque at baseline. In the multivariable analysis, we observed that, after adjusting for the Framingham score and the body mass index, the presence of a carotid plaque was significantly associated with the occurrence of a cardiovascular event: odds ratio [95% confidence interval] = 17.2 ; 95 CI: [1.15-2499]; p = 0.039).ConclusionSubclinical atherosclerosis defined as a carotid plaque >1.5 mm is significantly associated with the clinical cardiovascular risk in SLE. Subclinical atherosclerosis should be regularly assessed in this population as part of the global cardiovascular risk evaluation.

在明显心血管风险较低的狼疮患者中,亚临床动脉粥样硬化与未来心血管事件相关。
目的基于传统危险因素的预测模型低估了SLE患者心血管事件(CVE)的风险。我们的目的是根据SLE患者的基线亚临床动脉粥样硬化状态来评估CVE的发生。方法对2012年2月至2013年2月在我国国家罕见病参考中心连续随访的SLE患者进行颈动脉球囊内-中膜厚度(CIMT)的前瞻性评估。排除已知CVE的SLE患者。cimt> 1.5 mm将颈动脉斑块定义为亚临床动脉粥样硬化的指标。主要终点为CVE,定义为随访期间心肌梗死、缺血性卒中或症状性外周动脉疾病的发生。结果纳入63例SLE患者,其中82.5%为女性,中位年龄39岁[32-44.5]。其中,24人(38.1%)在基线时颈动脉斑块bbb1.5 mm, 7人(11.1%)在中位随访10.7年[8.2-11.0]年期间发生心血管事件。所有CVE发生在基线时有颈动脉斑块的患者组。在多变量分析中,我们观察到,在调整Framingham评分和体重指数后,颈动脉斑块的存在与心血管事件的发生显著相关:优势比[95%置信区间]= 17.2;[1.15-2499];P = 0.039)。结论亚临床动脉粥样硬化定义为颈动脉斑块>1.5 mm与SLE的临床心血管风险显著相关。亚临床动脉粥样硬化应作为全球心血管风险评估的一部分在这一人群中进行定期评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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