2022, Number 1
Factors associated with the appearance of subclinical atherosclerosis in systemic lupus erythematosus
Language: Spanish
References: 34
Page:
PDF size: 323.97 Kb.
ABSTRACT
Introduction: Systemic lupus erythematosus is an inflammatory, chronic, multisystemic disease, which is defined by its multiple clinical features and by the almost invariable presence of autoantibodies directed against one or more components of the cell nucleus.Objective: To characterize patients with Systemic Lupus Erythematosus and to identify its possible relationship with subclinical atherosclerosis.
Methods: A descriptive cross-sectional study of patients diagnosed with Systemic Lupus Erythematosus, treated at the Rheumatology Center in Havana, was carried out during the period from October 2015 to October 2017. The sample was non-probabilistic and consisted of 50 patients. Descriptive and inferential statistics were used.
Results: Of the total number of patients, 54.0% (n=27) had subclinical atherosclerosis. The traditional risk factors that showed association with the presence of plaque in patients with SLE were hypercholesterolemia, 70.4% (n=19) and hypertriglyceridemia 55.6% (n=15). A relationship was observed between the time of evolution, the presence of accumulated damage, renal compromise, CRP figures and accumulated dose of steroids, with the presence of subclinical atherosclerosis.
Conclusions: A higher average age was found in patients with SLE and presence of plaque. The traditional risk factors that showed association with the presence of atherosclerotic plaque were hypercholesterolemia and hypertriglyceridemia. An association was found between the time of evolution, the presence of accumulated damage, renal compromise, CRP figures and the accumulated dose of steroids, with the presence of plaque. In the study patients, the use of chloroquine was associated with the absence of subclinical atherosclerosis.
REFERENCES
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005 [Acceso 15/05/2017];112(17):2735-52. Disponible en: Disponible en: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.105.169404
Esdaile JM, Abrahamowicz M, Grodzicky T, Li Y, Panaritis C, du Berger R, et al. Traditional Framingham risk factors fail to fully account for accelerated atherosclerosis in systemic lupus erythematosus. Arthritis Rheum. 2001 [Acceso 03/05/2017];2001(10):2331-7. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/11665973/
Hernández Muñiz Y, Guibert Toledano ZM, Reyes Llerena GA. Correlación de las cifras de proteína C reactiva y aterosclerosis en pacientes con lupus eritematoso sistémico. Rev Cubana Reumatol. Ago 2015 [Acceso 03/05/2017];17(2):[aprox. 5 p.]. Disponible en: Disponible en: http://www.revreumatologia.sld.cu/index.php/reumatologia/article/view/414/pdf_18
Tan EM, Cohen AS, Fries JF, Masi AT, Mcshane DJ, Rothfield NF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum [Internet]. 1982 [Acceso 03/05/2017];25(11):1271-7. Disponible en: Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1002/art.1780251101
Doria A, Shoenfield Y, Wu R, Gambari PF, Puato M, Ghirardello A, et al. Risk factors for subclinical atherosclerosis in a prospective cohort of patients with systemic lupus erythematosus. Ann Rheum Dis. 2003 [Acceso 03/05/2017];62(11):1071-7. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/14583570/
Manzi S, Meilahn EN, Rairie JE, Conte CG, Medsger TA, Jansen-McWilliams, et al. Age-specific Incidente Rates of Myocardial Infarction and Angina in Women with Systemic Lupus Erythematosus: Comparison with the Framingham Study. Am J Epidemiol. 1997 [Acceso 03/05/2018];145(5):408-15. Disponible en: Disponible en: https://academic.oup.com/aje/article-abstract/145/5/408/120887
Petri M, Roubenoff R, Dallal GE, Nadeau MR, Selhub J, Rosenberg I. Plasma homocysteine as a risk factor for atherothrombotic events in systemic lupus erythematosus. Lancet. 1996 [Acceso 03/05/2018];348(9035):1120-4. Disponible en: Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0140673696030322
Guibert Toledano ZM, Reyes Llerena GA, Hernández Muñiz Y, Ugarte Moreno D, Miñoso Arafi Y. Morbilidad cardiovascular y evaluación de aterosclerosis en pacientes con lupus eritematoso sistémico. Rev Cubana Reumatol. Ago 2016 [Acceso 03/05/2018];18(2):[aprox. 7 p.]. Disponible en: Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S181759962016000200002&lng=es
Estévez del Toro M, Chico Capote A, Barahona Jorge RA, Jiménez Paneque R, Hernández Castro J. Prevalencia de enfermedad vascular aterosclerótica en pacientes cubanos con lupus eritematoso sistémico. Reumatol Clin. 2008 [Acceso 03/05/2018];4(1):13-8. Disponible en: Disponible en: https://www.sciencedirect.com/science/article/pii/S1699258X0871790X
Rodríguez Hernández R, Alberteris Rodríguez A, López Báster J, Diéguez Martínez M, Miguel-Soca PE, Cutié Anido Y. Factores de riesgo asociados a hipertensión arterial en pacientes con lupus eritematoso sistémico. Holguín, Cuba. Rev Haban Cienc Méd. Dic 2017 [Acceso 03/05/2018];16(6):[aprox. 4 p.]. Disponible en: Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1729519X2017000600011&lng=es
Stamler J, Wentworth D, Neaton JD. Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA [Internet]. 1986 [Acceso 03/05/2018];256:2823-8. Disponible en:Disponible en:https://jamanetwork.com/journals/jama/article-abstract/363231
Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005 [Acceso 03/05/2018];366:1267-78. Disponible en: Disponible en: https://www.thelancet.com/journals/lancet/article/PIIS0140673605673941/fulltext
Cacciapaglia F, Zardi EM, Coppoloni G, Buzzulini F, Margiotta D, Arcarece L, et al. Stiffness parameters, intima-media thickness and early aterosclerosis in systemic lupus erythematosus patients. Lupus. 2009 [Acceso 03/05/2018];18(3):249-56. Disponible en: Disponible en: https://journals.sagepub.com/doi/abs/10.1177/0961203308097571
Bruce IN, Urowitz MB, Gladman DD, Ibañez D, Steiner G. Risk factors for coronary heart disease in women with systemic lupus erythematosus: The Toronto Risk Factor Study. Arthritis Rheum. 2003 [Acceso 03/05/2018];48(11):3159-67. Disponible en: Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1002/art.11296
van Halm VP, Nurmohamed MT, Twisk JW, Dijkmans BA, Voskuyl AE. Disease modifying antirheumatic drugs are associated with a reduced risk for cardiovascular disease in patients with rheumatoid arthritis: a case control study. Arthritis Res Ther. 2006 [Acceso 03/05/2018];8(5):[aprox. 10 p.]. Disponible en: Disponible en: https://arthritis-research.biomedcentral.com/articles/10.1186/ar2045
Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandl LA, Manson JE, et al. Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation. 2003 [Acceso 03/05/2018];107(9):1303-7. Disponible en: Disponible en: https://www.ahajournals.org/doi/abs/10.1161/01.CIR.0000054612.26458.B2