Prevalence of coronary artery calcification in young patients with SLE of predominantly Hispanic and African–American descent

摘要

Objectives Cardiovascular disease (CVD) is a leading cause of death in SLE. Coronary artery calcium (CAC) scores predict CVD events, independent of traditional risk factors. Patients with SLE aged 45 years have an increased prevalence of CAC in a predominantly white population. Little is known about CAC in younger patients with SLE. We evaluated CAC in younger patients with SLE of predominantly African–American and Hispanic ancestry, compared with healthy controls.Methods We identified 76 patients with SLE meeting 1997 American College of Rheumatology classification criteria, without known coronary artery disease and who had a non-contrast chest CT performed as part of their clinical care, with images retrievable for calculation of CAC scores. Demographics, disease characteristics and comorbidities were ascertained and adjusted for.Results 42.1% of patients with SLE (mean age 40±13 years, 90% female, 33% Hispanic and 40% African–American) had CAC0, 32% for age ≤45 years?and 61.6% for age 45. Patients with SLE with CAC0 were older and had more comorbid hypertension. Women with SLE aged ≤45 years, had a 12.6-fold higher adjusted odds of CAC0 compared with age-matched and sex-matched controls (95%?CI 5.2 to 30.7, p0.001). Furthermore, 29% of patients with SLE aged 18–32 years (median disease duration of 5 years) had CAC0.Conclusion Patients with SLE aged ≤45 years have an increased prevalence of detectable CAC compared with the general population. Our data suggest that subclinical atherosclerosis in SLE develops early and warrants timely screening and cardioprotective interventions.