TY - JOUR T1 - Vascular Imaging as a Cardiovascular Risk Stratification Tool in Systemic Lupus Erythematosus JF - The Journal of Rheumatology JO - J Rheumatol SP - 2141 LP - 2143 DO - 10.3899/jrheum.090640 VL - 36 IS - 10 AU - STAVROS APOSTOLAKIS AU - EDUARD SHANTSILA AU - GREGORY Y.H. LIP Y1 - 2009/10/01 UR - http://www.jrheum.org/content/36/10/2141.abstract N2 - Systemic lupus erythematosus (SLE) is an autoimmune disorder associated with increased incidence of cardiovascular disease (CVD) and consequently, a higher rate of cardiovascular events1. This association has been mainly established on epidemiological data and, given that patients with SLE are predominantly premenopausal women, this excess in CVD risk might appear somewhat unexpected1,2.Fifty years ago, only 50% of patients with SLE survived 5 years after diagnosis; but today, with better therapeutic strategies, the disease outcome is better, and 80% to 90% of patients survive at least 10 years after SLE is diagnosed3. With the increased life expectancy of patients with SLE, CVD has perhaps emerged as a more significant threat to their health. For a long time, the effect of this problem has been under-recognized, with little focus on aggressive management of CVD risk factors or the development of risk stratification strategies. The high risk for CVD in patients with SLE was substantiated by studies that assessed the incidence of major cardiovascular events and studies that noninvasively evaluated the atherosclerotic burden in SLE. Almost 3 decades ago, Urowitz, et al followed up 81 SLE patients for 5 years and reported that in the majority of those who died late in the course of the disease, myocardial infarction was the primary cause of death3. These authors first described a phenomenon that is still known as the “bimodal mortality pattern” of SLE. Recent prospective studies have also confirmed this unusual bimodal pattern of mortality in SLE. Manzi, et al4 reported that women with SLE at the age of 35 to 44 years were over 50 times more likely to have a myocardial infarction than women of similar age in the Framingham Offspring Study. The authors concluded that CVD was much more … Address correspondence to Prof. Lip. E-mail:g.y.h.lip{at}bham.ac.uk ER -