Peripheral Arterial Disease in Systemic Lupus Erythematosus: Prevalence and Risk Factors

2014 ◽  
Vol 41 (2) ◽  
pp. 310-317 ◽  
Author(s):  
Jose Gabriel Erdozain ◽  
Irama Villar ◽  
Javier Nieto ◽  
Guillermo Ruiz-Irastorza
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Peripheral Arterial Disease ◽  
Lupus Erythematosus ◽  
Univariate Analysis ◽  
Ankle Brachial Index ◽  
Vascular Risk Factor ◽  
Arterial Disease ◽  
Systemic Lupus ◽  
Peripheral Arterial

Objective.To analyze the prevalence of peripheral arterial disease (PAD) and cardiovascular (CV) risk factors in a cohort of patients with systemic lupus erythematosus (SLE) and to identify variables potentially related to PAD.Methods.The study included 216 patients with SLE from the Lupus-Cruces prospective observational cohort. The ankle brachial index (ABI) was determined in each patient, with values < 0.9 considered diagnostic of PAD. Demographic and clinical variables, presence of traditional risk factors and CV events, cardiovascular risk calculated by Systematic Coronary Risk Evaluation (SCORE), and treatments received by each patient were analyzed.Results.Ninety-two percent of patients were women. The mean age (SD) was 49 years (15), with a mean followup (SD) of 12 years (9). The prevalence of low ABI was 21%. CV risk factors were frequent: smoking, 30% of patients; high blood pressure, 32.7%; diabetes mellitus, 3.2%; hypercholesterolemia, 34.1%; and metabolic syndrome, 9.7%. The following variables were associated with low ABI in the univariate analysis: age (p < 0.001), hypertension (p = 0.002), diabetes (p = 0.018), hypercholesterolemia (p = 0.018), CV events (p < 0.001), SCORE (p = 0.004), cumulative dose of cyclophosphamide (p = 0.03), and fibrinogen levels (p = 0.002). In the multivariate analysis, the only independent variable in the final model was age (OR 1.04, 95% CI 1.02–1.07, p < 0.001), with a tendency for the presence of any vascular risk factor (diabetes, hypertension, hypercholesterolemia, or current smoking; OR 2.3, 95% CI 0.99–5.1, p = 0.053).Conclusion.The prevalence of low ABI in patients with SLE is higher than expected. While the association with CV risk factors and vascular disease in other territories was strong, we could not identify SLE-specific variables independently associated with PAD.

Arterial stiffness and peripheral arterial disease in patients with systemic lupus erythematosus

2016 ◽  
Vol 37 (2) ◽  
pp. 293-298 ◽  
Author(s):  
Konstantinos Tziomalos ◽  
Ioannis Gkougkourelas ◽  
Alexandros Sarantopoulos ◽  
Eleni Bekiari ◽  
Evangelia Makri ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Arterial Stiffness ◽  
Peripheral Arterial Disease ◽  
Lupus Erythematosus ◽  
Arterial Disease ◽  
Systemic Lupus ◽  
Peripheral Arterial

scholarly journals Prevalence of Carotid Artery Atherosclerosis Plaque in Systemic Lupus Erythematosus in Hasan Sadikin Hospital Bandung in 2017-2018

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Irham Rasyid ◽  
Syarief Hidayat ◽  
Laniyati Hamijoyo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Carotid Artery ◽  
Peripheral Arterial Disease ◽  
Atherosclerotic Plaque ◽  
Lupus Erythematosus ◽  
Arterial Disease ◽  
Inclusion Criteria ◽  
Systemic Lupus ◽  
Carotid Artery Atherosclerosis ◽  
Peripheral Arterial

Background. Systemic Lupus Erythematosus (SLE) is an autoimmune disease involving many organs including the cardiovascular system such as accelerated atherosclerosis or premature atherosclerosis. Atherosclerotic plaque can cause coronary heart disease, ischemic stroke and peripheral arterial disease, which are the main causes of death in the world. The purpose of this study was to determine the prevalence of carotid artery atherosclerosis plaques in patients with SLE. Method. This research is a descriptive study with a cross-sectional design. Carotid artery atherosclerosis plaques in SLE patients were assessed by analysing results of carotid ultrasound examinations that were conducted in 2017-2018. The inclusion criteria of this study were SLE patients who had undergone carotid doppler ultrasound B mode examination on the carotid artery for the period of 2017-2018. The exclusion criteria in this study were SLE patients with a history of stroke, peripheral arterial disease, and significant coronary artery disease. Result. This study involved 88 SLE patients who met the inclusion criteria. Results showed that there were 10 SLE patients (11.4%) who had atherosclerotic plaques. SLE patients with atherosclerosis plaque were mostly in the age range of 35-44 years (16%) and 45-54 years (22.2%). There were 2 patients (15.3%) with atherosclerotic plaque from a total of 11 patients had high triglyceride levels (≥150 mg/dL). Chi square analysis of lipid profiles (cholesterol, LDL, HDL, triglycerides) in patients with atheroclerotic plaque revealed not significant (p>0.05). These findings could be caused by several factors, such as the small number of samples in this study and the non-traditional factors in the formation of atherosclerotic plaque as well as other traditional factors Conclusion. The prevalence of carotid artery atherosclerosis plaques in patients with SLE in Dr. Hasan Sadikin General Hospital in 2017-2018 is 11.4%.

scholarly journals Semiquantified Noncalcified Coronary Plaque in Systemic Lupus Erythematosus

2012 ◽  
Vol 39 (12) ◽  
pp. 2286-2293 ◽  
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.

Abstract 278: Lipid Control in Patients With New Symptoms of Peripheral Arterial Disease Evaluated at Vascular Specialty Clinics

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Kim Smolderen ◽  
Jan-Willem Elshof ◽  
Moniek van Zitteren ◽  
John A Spertus ◽  
Johan Denollet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Secondary Prevention ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Initial Evaluation ◽  
Specialty Clinic ◽  
Lipid Control ◽  
Peripheral Arterial

Background: Obtaining adequate lipid control (LDL-Cholesterol [LDL] <100 mg/dL) in patients with peripheral arterial disease (PAD) is a critical, guideline-directed secondary prevention target. Current compliance with this recommendation is unknown. Methods: A total of 616 patients had their LDL levels measured at 2 vascular specialty clinics in the Netherlands (March 2006-November 2011) during the evaluation of new PAD symptoms. A year following this evaluation, 417 (68%) patients had their LDL levels re-assessed. Information about patients’ demographic and clinical factors was systematically abstracted from medical records. Categories of patients were created based on the attainment of the recommended LDL target (<100 mg/dL [on target] vs. ≥100 mg/dL [off target]). Predictors of being off target at initial evaluation and at 1-year follow-up were identified through multivariable logistic regression analyses. Results: Of the total group, 57% (351/616) were off target at initial evaluation and 81% (496/616) were on lipid-lowering drugs after the initial evaluation at the PAD specialty clinic. One year later, only 25% (103/417) got on target, while 35% (147/417) patients remained off target, and an additional 10% (43/417) saw an increase in LDL to become off target. A total of 30% (124/417) remained on target. Patients with hypertension, diabetes, a history of myocardial infarction, and a lower ankle-brachial index were less likely to be off target at initial evaluation. Predictors of being off target at 1-year follow-up were male sex, and having a higher ankle-brachial index ( Table ). Conclusion: About half of patients with PAD seen at vascular specialty clinics had above-target LDL levels both upon entry and 1 year later. Patients with existing cardiovascular risk factors were much better controlled, as compared with patients without such risk factors. Males and those with higher ankle-brachial indices were less likely to be on target 1 year following management at the specialty clinic. Reasons for poorly regulated lipids need to be further explored, and appropriate quality-of-care improvement strategies will likely be needed to optimize secondary prevention.

scholarly journals Prevalence and predictors of peripheral arterial disease determined by ankle brachial index in diabetes population treated within primary care services in a non-urban area of lower northern Thailand

2020 ◽  
Vol 17 (6) ◽  
pp. 147916412096699
Author(s):  
Preaw Suwannasrisuk ◽  
Sarinya Sattanon ◽  
Watcharaporn Taburee ◽  
Pantitra Singkheaw ◽  
Non Sowanna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
University Hospital ◽  
Peripheral Arterial ◽  
Diabetes Patients

In diabetes patients, urban lifestyle has been concerned as one of the risk factors for peripheral arterial disease (PAD). The aims of this study were to find out the prevalence and associated risk factors of PAD in type 2 diabetes patients who live in a non-urban community area. A total of 885 participants with type 2 diabetes mellitus were enrolled from six primary care units in the health network centered at Naresuan University Hospital, Phitsanulok, between May and June 2018. Ankle-brachial index (ABI) was performed in all subjects using a vascular screening device. PAD was defined by an ABI value of 0.9 or lesser at least on one leg. The predictors of PAD were analyzed using multiple logistic regression. The prevalence of PAD was 7.2% among 884 evaluable patients. Diabetic neuropathy and a history of macrovascular complications were significant predictors of PAD.

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