PT  - JOURNAL ARTICLE
AU  - Adnan N.  Kiani
AU  - Jens Vogel-Claussen
AU  - Armin Zadeh
AU  - Laurence S.  Magder
AU  - Joao Lima
AU  - Michelle Petri
TI  - Semiquantified Noncalcified Coronary Plaque in Systemic Lupus Erythematosus
AID  - 10.3899/jrheum.120197
DP  - 2012 Oct 01
TA  - The Journal of Rheumatology
PG  - jrheum.120197
4099  - http://www.jrheum.org/content/early/2012/09/27/jrheum.120197.short
4100  - http://www.jrheum.org/content/early/2012/09/27/jrheum.120197.full
AB  - 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.