Increased Arterial Stiffness Observed in Patients With Systemic Lupus Erythematosus

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Patients with SLE showed increased arterial stiffness compared with healthy control patients, although there were no differences with respect to standard cardiovascular risk factors.
Patients with SLE showed increased arterial stiffness compared with healthy control patients, although there were no differences with respect to standard cardiovascular risk factors.

Patients with systemic lupus erythematosus (SLE) exhibit increased central arterial stiffness, as measured by the augmentation index, compared with a healthy control population. In addition, patients with SLE who are treated with antimalarial drugs demonstrate decreased arterial stiffness, according to the results of a cross-sectional study published in Arthritis Care & Research.

The investigators sought to examine the metabolic and immunologic factors associated with the presence of central arterial thickness among patients with SLE, as assessed by augmentation index. A total of 69 women with SLE and 34 healthy control patients at Saint Joan University Hospital in Reus, Spain, were enrolled in the study. On the day of study initiation, clinical, biochemical, and vascular data were obtained from all participants. Augmentation index was evaluated using peripheral arterial tonometry. In all participants, an analysis of lipoprotein populations was conducted with the use of 1H nuclear magnetic resonance imaging.

Patients with SLE exhibited significantly increased arterial stiffness compared with the control patients (20.30% vs 10.84%; P =.0021). Augmentation index values were significantly associated with Framingham risk scores (r=0.486; P <.001), carotid intima media thickness (r=0.503; P <.001), systolic blood pressure (r=0.456; P <.001), and age (r=0.456; P <.001). Patients with SLE who were being treated with antimalarial drugs demonstrated significantly lower augmentation index values compared with those not receiving antimalarial therapy (11.74% vs 24.97%, respectively; P =.024).

Augmentation index was linked to the atherogenic lipoproteins that were analyzed using nuclear magnetic resonance imaging. The immunologic variables associated with augmentation index included C4 (r=0.259; P =.046) and immunoglobulin M (IgM)-β2-glycoprotein I (r=0.284; P =.284). Multivariate analysis showed that age (β=0.347; 95% CI, 0.020-0.669; P =.035), IgM-β2-glycoprotein I (β=0.321; 95% CI, 0.024-0.618; P =.035), and proinflammatory small high-density lipoprotein (HDL) particles (β=1.288; 95% CI, 0.246-2.329; P =.017) were all significantly predictive of augmentation index.

The investigators concluded that patients with SLE who are treated with antimalarial agents exhibit less arterial stiffness, determined by age, IgM-β2-glycoprotein I level, and number of small, dense HDL particles. The researchers recommend that the findings of this study be validated in a larger cohort of patients to confirm the results. 

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Reference

Parra S, Lopez-Dupla M, Ibarretxe D, et al. SLE patients show an increased arterial stiffness that is predicted by IgM-anti-ß2 -glycoprotein I and small dense HDL particles [published online May 9, 2018]. Arthritis Care Res (Hoboken). doi: 10.1002/acr.23594.

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