PRE-MATURE ATHEROSCLEROTIC CORONARY ARTERY DISEASE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

S ystemic lupus erythematosus (SLE) is a multisystem autoimmune disease with a strong female predilection. Cardiovascular morbidity and mortality is a frequent complication, particularly in young aged females, in whom the risk is raised up to 50-fold Patients with SLE are at increased risk of premature atherosclerosis. The mechanisms underlying this increased risk are not fully understood. Certain traditional risk factors, such as hyperlipidemia, are more common in SLE patients than in the general population. These factors do not, however, completely account for the increased cardiovascular risk; factors such as increased anti-ox LDL, CRP level, nephritis and high disease activity probably have a role. In addition, several factors more-specifically related to lupus are proposed to be of importance, including chronic inflammation and therapy, especially corticosteroid use. The aim of this study was to assess the increased risk of early atherosclerosis in lupus patients and to evaluate the effect of certain risk factors such as dyslipidemia, elevated anti ox-LDL antibodies titer, disease activity, disease duration and steroid therapy on the increased risk of CAD in those patients. This study was done on sixty premenopausal SLE patients selected from internal medicine department and rheumatology out- patient clinic of Ain Shams university hospital. All patients were fulfilling the ACR criteria for diagnosis of SLE. Sixty age and sex matched healthy volunteers, were chosen as a control group.