CHSJ

Curr Health Sci J, vol. 37, no. 4, 2011

Disease Activity and Subclinical Atherosclerosis in Systemic Lupus Erythematosus

[Original paper]

A.L. BARBULESCU(1), F. VREJU(2), A.E. MUSETESCU(2), I.R COJOCARU-GOFITA(2), P.L CIUREA(2)


(1)Department of Internal Medicine, University of Medicine and Pharmacy Craiova;
(2)Department of Rheumatology, University of Medicine and Pharmacy Craiova


Abstract:

Background: Atherosclerosis is the most common pathologic process leading to cardiovascular disease and systemic immune and inflammatory diseases, such as systemic lupus erythematosus (SLE), are associated with increased morbidity and mortality, most of it attributable to cardiovascular events. Non invasive measurement of arterial stiffness allows the detection of early vascular injury and help the clinicians improve the long term prognosis of these patients. The aim of this study was to evaluate the relationship between non invasive vascular assessment and SLE disease activity index. Methods: Our prospective study included 53 patients with SLE, from Rheumatology department, Emergency County Hospital Craiova. All of them have fulfilled the American College of Rheumatology revised criteria for SLE. Results: As expected, most of the patients were women (50, 94%), with a a mean age of 31,92 years (SD 5,55; limits 22-44), similar in women and men. Patients with persistent active disease (SLEDAI>8), had a mean  AIx  of 35,91% (SD 7,04; 95%CI 32,786 - 39,032), 1,31 times higher than the ones with SLEDAI<8 (27,39%; SD 5,89; 95%CI 25,228 - 29,546), statistically significant (p<0,001), a higher cfPWV-9,523m/s (DS 0,407; 95%CI 9,342-9,703), but not statistically significant (p=0,301) and a mean CIMT of 0,909mm (SD 0,03182; 95%CI 0,895-0,923) versus 0,897mm (SD 0,03699; 95%CI95% 0,884-0,911) in patients with SLEDIA<8, with no significant differences (p=0,242). AIx was the only marker of subclinical atherosclerosis that moderately correlated with SLEDAI (r=0,46; 95%CI 0,2134 - 0,6476; p<0,001). Conclusion: The results of our study show that SLEDAI significantly correlated with AIx, suggesting that disease flare or aggravation may play a permissive role in vascular injury through vascular inflammation and endothelial dysfunction, which will decrease arterial compliance.


Keywords: systemic lupus erythematosus, SLEDAI, augmentation index, pulse wave velocity, intima-media thickness



Corresponding: Barbulescu Andreea MD, PhD Stud, Department of Internal Medicine, University of Medicine and Pharmacy Craiova, Str Petru Rares nr. 4, 200456, Craiova, Dolj, RomAnia; mail: anbarbulescu@yahoo.com


DOI 10.12865/CHSJ.37.04.09 - Download PDF
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