Dr. Ardoin has received consultancy fees, speaking fees, and/or honoraria (less than $10,000) from Johnson & Johnson.
Systemic Lupus Erythematosus
Association of systemic lupus erythematosus with angiographically defined coronary artery disease: A retrospective cohort study
Version of Record online: 30 JAN 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 2, pages 266–273, February 2013
How to Cite
Kaul, M. S., Rao, S. V., Shaw, L. K., Honeycutt, E., Ardoin, S. P. and St.Clair, E. W. (2013), Association of systemic lupus erythematosus with angiographically defined coronary artery disease: A retrospective cohort study. Arthritis Care Res, 65: 266–273. doi: 10.1002/acr.21782
- Issue online: 30 JAN 2013
- Version of Record online: 30 JAN 2013
- Accepted manuscript online: 28 JUN 2012 09:31AM EST
- Manuscript Accepted: 16 JUN 2012
- Manuscript Received: 16 DEC 2010
- NIH National Institute of Allergy and Infectious Diseases. Grant Number: T32-AI007217
- Department of Medicine at Duke University Medical Center
To determine if systemic lupus erythematosus (SLE) is associated with a higher prevalence of coronary artery disease (CAD) in select patients undergoing coronary angiography. We compared the extent of angiographic abnormalities, CAD risk factors, and all-cause mortality in SLE patients with non-SLE controls.
We identified SLE patients (n = 86) and controls matched by sex and year of cardiac catheterization (n = 258) undergoing cardiac catheterization for the evaluation of CAD (median followup duration of 4.3 years). Multivariable logistic regression was used to determine if SLE was associated with obstructive CAD, defined as ≥70% stenosis in a major epicardial coronary artery. Risk-adjusted survival differences between the 2 groups were assessed using Cox proportional hazards modeling.
The SLE patients (85% women) were younger than the non-SLE patients (median age 49 years versus 70 years; P < 0.001) and were less likely to have diabetes mellitus and hyperlipidemia, but had similar rates of hypertension (70% versus 71%; P = 0.892). In unadjusted analyses, SLE and non-SLE patients had similar rates of obstructive CAD by angiography (52% versus 62%; overall P = 0.11). After adjustment for known CAD risk factors, SLE was associated with a significantly increased likelihood of CAD (odds ratio 2.24 [95% confidence interval (95% CI) 1.08–4.67]). SLE was also associated with a nonsignificant increase in all-cause mortality (hazard ratio 1.683 [95% CI 0.98–2.89], P = 0.060).
In this selected population, SLE was significantly associated with the presence of CAD as defined by coronary angiography, the gold standard for assessing flow-limiting lesions in this disease. The patients with SLE showed a similar severity of CAD as the controls despite having less than half the rate of diabetes mellitus and being 20 years younger.