Abstract
Objective
Several mediators of inflammation are associated with atherosclerotic cardiovascular disease in the general population, but their relationship to accelerated atherosclerosis associated with an inflammatory disease such as systemic lupus erythematosus (SLE) is not known.
Methods
We compared concentrations of cytokines (TNF-α, IL-1α, and VEGF), inflammatory enzymes (MPO and MMP-9), acute-phase reactants (ESR, CRP, and SAA) and adhesion molecules (VCAM, ICAM, and E-selectin) in 109 patients with SLE and 78 controls. The relationship between inflammatory markers and coronary atherosclerosis detected as calcified plaque by electron beam CT was determined in patients with SLE.
Results
Concentrations of all markers of inflammation other than VCAM, MMP-9, and IL-1α were significantly higher in SLE. In multivariable analyses adjusting for Framingham risk score, cumulative corticosteroid dose, and diabetes, E-selectin (OR 1.90, 95% CI 1.08–3.33), VCAM (OR 1.99, 1.18–3.37), ICAM (OR 2.30, 1.13–4.7), and TNF-α (OR 2.36, 1.10–5.06) were significantly associated with the severity of coronary calcium.
Conclusion
Concentrations of adhesion molecules and TNF-α are associated with coronary atherosclerosis in SLE independent of the Framingham risk score.
Key Indexing Terms:Footnotes
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Y.H. Rho, MD; C.P. Chung, MD, MPH; A. Oeser, BS, Divisions of Clinical Pharmacology and Rheumatology; J. Solus, PhD, Departments of Molecular Physiology and Biophysics, Vanderbilt University; P. Raggi, MD, Division of Cardiology, Emory University; T. Gebretsadik, MPH; A. Shintani, PhD, MPH, Department of Biostatistics, School of Medicine; C.M. Stein, MD, Divisions of Clinical Pharmacology and Rheumatology, Vanderbilt University.
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Supported by NIH grants HL65082 and GM5M01-RR00095.
- Accepted for publication April 11, 2008.