Detectable Coronary Artery Calcium Prevalent in Young Patients With Systemic Lupus Erythematosus

Patients with systemic lupus erythematosus (SLE) aged ≤45 years are more likely to have detectable coronary artery calcium (CAC) compared with the general population, according to study results published in Lupus Science and Medicine.

The results suggest that subclinical atherosclerosis develops early in patients with SLE, highlighting the need for timely screening and cardioprotective interventions.

The study included patients (n=76) with SLE aged 18 to 64 years who met the 1997 American College of Rheumatology classification criteria and had no known coronary artery disease. The study also included age- and sex-matched controls (n=3042). Patients had noncontrast chest computed tomography performed as part of their clinical care, which was used by the researchers to calculate CAC scores. They also obtained patient demographics, disease characteristics, and comorbidities.

The mean age of patients was 40±13 years; 33% were of Hispanic ancestry and 40% were African American.

Among patients with SLE, 42.1% had CAC >0, including 32% of those aged ≤45 years and 61.6% aged >45 years.

Compared with patients with SLE and CAC =0, those with SLE and CAC >0 were more likely to be older (45±15 vs 37±12 years; P =.01) and to have comorbid hypertension (56% vs 34%; P =.05). The researchers did not find any associations between CAC-specific and SLE-specific characteristics.

The results indicated that women with SLE aged ≤45 years had 12.6-fold higher adjusted odds of CAC >0 compared with age- and sex-matched controls (95% CI, 5.2-30.7; P <.001).

“The high prevalence in this young, predominantly female, minority population is disquieting and warrants further investigation and longitudinal follow-up,” the researchers wrote.

Reference

Gartshteyn Y, Braverman G, Mahtani S, Geraldino-Pardilla L, Bokhari S, Askanase, A. Prevalence of coronary artery calcification in young patients with SLE of predominately Hispanic and African American descent. Lupus Sci Med. 2019;6:e000330.