AB0644 Cardiovascular risk factors and carotid intima-media thickness in systemic lupus erythematosus

IntroductionAccelerated atherosclerosis is a major complication of systemic lupus erythematosus (SLE), and it leads to increased cardiovascular morbidity and mortality in patients with SLE. This study aimed to investigate the natural progression of carotid intima-media thickness (CIMT), and to examine the risk factors for progression of CIMT and atherosclerotic plaques based on a Chinese SLE cohort.Methods and analysisParticipants were continuously enrolled as outpatients of the Department of Rheumatology in Peking Union Medical College Hospital (PUMCH) from October 2013 to December 2016. Inclusion criteria were as follows: (1) age ≥18 years, (2) fulfilment of clinical classification criteria of SLE and (3) provision of signed written informed consent. Patients with clinically overt coronary artery disease, a history of cardiovascular disease (previous stroke, heart failure, myocardial infarction, angina or symptomatic peripheral artery disease) and malignancy, and pregnant/lactating women were excluded. The primary outcome is progression of CIMT from baseline. A total of 440 patients with SLE will be enrolled. Participants will receive follow-up surveys ~5 years after their baseline visit. A standard structural survey form, including demographic data, medical history, clinical and laboratory assessments and CIMT measurement, is planned for data collection at baseline and follow-up. The risk prediction model for progression of CIMT will be created by using a mixed effect model.Ethics and disseminationThe study protocol was approved by the institutional review board of PUMCH (S-599). Informed consent was obtained from all participants according to the Declaration of Helsinki on Biomedical Research Involving Human Studies. All data will be managed confidentially according to guidelines and legislation. Dissemination will include publication of scientific papers and/or presentations of the study findings at international conferences.

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Systemic lupus erythematosus: the influence of disease-related and classical risk factors on intima media thickness and prevalence of atherosclerotic plaques - a preliminary report. Beneficial effect of immunosuppressive treatment on carotid intima media thickness

Acta Cardiologica ◽

10.1080/ac.70.2.3073508 ◽

2015 ◽

Vol 70 (2) ◽

pp. 169-175 ◽

Cited By ~ 10

Author(s):

Bart³omiej Kisiel ◽

Robert Kruszewski ◽

Aleksandra Juszkiewicz ◽

Anna Raczkiewicz ◽

Artur Bachta ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Preliminary Report ◽

Immunosuppressive Treatment ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Atherosclerotic Plaques ◽

Systemic Lupus ◽

Media Thickness

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Meta-analysis of epigenome-wide association studies of carotid intima-media thickness

European Journal of Epidemiology ◽

10.1007/s10654-021-00759-z ◽

2021 ◽

Author(s):

Eliana Portilla-Fernández ◽

Shih-Jen Hwang ◽

Rory Wilson ◽

Jane Maddock ◽

W. David Hill ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dna Methylation ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Association Studies ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness

AbstractCommon carotid intima-media thickness (cIMT) is an index of subclinical atherosclerosis that is associated with ischemic stroke and coronary artery disease (CAD). We undertook a cross-sectional epigenome-wide association study (EWAS) of measures of cIMT in 6400 individuals. Mendelian randomization analysis was applied to investigate the potential causal role of DNA methylation in the link between atherosclerotic cardiovascular risk factors and cIMT or clinical cardiovascular disease. The CpG site cg05575921 was associated with cIMT (beta = −0.0264, p value = 3.5 × 10–8) in the discovery panel and was replicated in replication panel (beta = −0.07, p value = 0.005). This CpG is located at chr5:81649347 in the intron 3 of the aryl hydrocarbon receptor repressor gene (AHRR). Our results indicate that DNA methylation at cg05575921 might be in the pathway between smoking, cIMT and stroke. Moreover, in a region-based analysis, 34 differentially methylated regions (DMRs) were identified of which a DMR upstream of ALOX12 showed the strongest association with cIMT (p value = 1.4 × 10–13). In conclusion, our study suggests that DNA methylation may play a role in the link between cardiovascular risk factors, cIMT and clinical cardiovascular disease.

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Semiquantified Noncalcified Coronary Plaque in Systemic Lupus Erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.120197 ◽

2012 ◽

Vol 39 (12) ◽

pp. 2286-2293 ◽

Cited By ~ 14

Author(s):

ADNAN N. KIANI ◽

JENS VOGEL-CLAUSSEN ◽

ARMIN ARBAB-ZADEH ◽

LAURENCE S. MAGDER ◽

JOAO LIMA ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Lupus Erythematosus ◽

Univariate Analysis ◽

Coronary Plaque ◽

Systemic Lupus ◽

History Of ◽

Noncalcified Plaque

Objective.A major cause of morbidity and mortality in systemic lupus erythematosus (SLE) is accelerated coronary atherosclerosis. New technology (computed tomographic angiography) can measure noncalcified coronary plaque (NCP), which is more prone to rupture. We report on a study of semiquantified NCP in SLE.Methods.Patients with SLE (n = 147) with no history of cardiovascular disease underwent 64-slice coronary multidetector computed tomography (MDCT). The MDCT scans were evaluated quantitatively by a radiologist, using dedicated software.Results.The group of 147 patients with SLE was 86% female, 70% white, 29% African American, and 3% other ethnicity. The mean age was 51 years. In our univariate analysis, the major traditional cardiovascular risk factors associated with noncalcified plaque were age (p = 0.007), obesity (p = 0.03; measured as body mass index), homocysteine (p = 0.05), and hypertension (p = 0.04). Anticardiolipin (p = 0.026; but not lupus anticoagulant) and anti-dsDNA (p = 0.03) were associated with higher noncalcified plaque. Prednisone and hydroxychloroquine therapy had no effect, but methotrexate (MTX) use was associated with higher noncalcified plaque (p = 0.0001). In the best multivariate model, age, current MTX use, and history of anti-dsDNA remained significant.Conclusion.Our results suggest that serologic SLE (anti-dsDNA) and traditional cardiovascular risk factors contribute to semiquantified noncalcified plaque in SLE. The association with MTX is not understood, but should be replicated in larger studies and in multiple centers.

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