Accelerated atherosclerosis in patients with systemic lupus erythematosus: a review of the causes and possible prevention.

Systemic lupus erythematosus is an autoimmune disorder affecting multiple organ systems. Patients with systemic lupus erythematosus exhibit a bimodal pattern of mortality, with those who have had the disease for 5 to 10 years being at increased risk of cardiovascular disease, particularly myocardial infarction. Elevated levels of conventional cardiovascular risk factors promote vascular damage resulting in impairment of normal endothelial function. In addition, autoantibodies directed against oxidised lipoproteins, along with chronic secretion of inflammatory cytokines and suppression of fibrinolytic parameters, are thought to increase atherogenesis. Treatment with corticosteroids may also contribute to the accelerated atherosclerosis observed in these patients. This review discusses the accentuated relationship between conventional cardiovascular risk factors, systemic lupus erythematosus-induced inflammatory changes and the early stages of atherogenesis and how careful monitoring of risk factors and use of appropriate therapies may reduce the progression of atheroma development in patients with systemic lupus erythematosus.

[1]  A. Levin,et al.  Cardiovascular disease in chronic renal insufficiency. , 2000, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[2]  M. Ward.  Cardiovascular and cerebrovascular morbidity and mortality among women with end-stage renal disease attributable to lupus nephritis. , 2000, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[3]  D. Gladman,et al.  Effect of antimalarial agents on the fasting lipid profile in systemic lupus erythematosus. , 2000, The Journal of rheumatology.

[4]  C. Lam,et al.  Hydroxychloroquine has no significant effect on lipids and apolipoproteins in Chinese systemic lupus erythematosus patients with mild or inactive disease , 2000, Lupus.

[5]  S. Textor,et al.  Outcomes of atherosclerotic renal artery stenosis managed without revascularization. , 2000, Mayo Clinic proceedings.

[6]  C. Lau,et al.  A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population. , 2000, Rheumatology.

[7]  C. Aranow,et al.  Epidemiology of cardiovascular disease in systemic lupus erythematosus , 2000, Lupus.

[8]  J. Pearson.  Normal endothelial cell function , 2000, Lupus.

[9]  T. Koike,et al.  Accelerated atheroma and anti-β2-glycoprotein I antibodies , 2000, Lupus.

[10]  O. Vaarala.  Antibodies to oxidised LDL , 2000, Lupus.

[11]  B. Hunt.  The endothelium in atherogenesis , 2000, Lupus.

[12]  P. Libby.  Changing concepts of atherogenesis , 2000, Journal of internal medicine.

[13]  D. Gladman,et al.  Accelerated atheroma in lupus—background , 2000, Lupus.

[14]  B. Tomlinson,et al.  Guidelines for healthy weight. , 1999, The New England journal of medicine.

[15]  T. Ogihara,et al.  Human prostacyclin synthase gene and hypertension : the Suita Study. , 1999, Circulation.

[16]  I. Bruce,et al.  Natural history of hypercholesterolemia in systemic lupus erythematosus. , 1999, The Journal of rheumatology.

[17]  W. Sessa,et al.  erratum: Regulation of endothelium-derived nitric oxide production by the protein kinase Akt , 1999, Nature.

[18]  C. Lau,et al.  Lupus nephritis in Southern Chinese patients: clinicopathologic findings and long-term outcome. , 1999, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[19]  G. Lowe,et al.  Relationship between smoking and cardiovascular risk factors in the development of peripheral arterial disease and coronary artery disease: Edinburgh Artery Study. , 1999, European heart journal.

[20]  M. Ward.  Premature morbidity from cardiovascular and cerebrovascular diseases in women with systemic lupus erythematosus. , 1999, Arthritis and rheumatism.

[21]  R. Foley,et al.  Cardiovascular disease and mortality in ESRD. , 1998, Journal of nephrology.

[22]  D. Webb,et al.  Endothelin as a regulator of cardiovascular function in health and disease , 1998, Journal of hypertension.

[23]  R. Rosenson,et al.  Antiatherothrombotic properties of statins: implications for cardiovascular event reduction. , 1998, JAMA.

[24]  J. Sanderson,et al.  New risk factors for coronary heart disease in Asia. , 1997, International journal of cardiology.

[25]  R. Rossen.  HMG-CoA reductase inhibitors: a new class of anti-inflammatory drugs? , 1997, Journal of the American College of Cardiology.

[26]  A. Folsom,et al.  Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993. , 1997, American journal of epidemiology.

[27]  D. Steinberg,et al.  Lewis A. Conner Memorial Lecture. Oxidative modification of LDL and atherogenesis. , 1997, Circulation.

[28]  M. E. Ramirez,et al.  Evidence for sex steroid inhibition of lipoprotein lipase in men: comparison of abdominal and femoral adipose tissue. , 1997, Metabolism: clinical and experimental.

[29]  I. Rosenberg,et al.  Plasma homocysteine as a risk factor for atherothrombotic events in systemic lupus erythematosus , 1996, The Lancet.

[30]  A. Tchernof,et al.  Obesity and metabolic complications: contribution of dehydroepiandrosterone and other steroid hormones. , 1996, The Journal of endocrinology.

[31]  D. Wagner,et al.  Adhesion molecules--Part II: Blood vessels and blood cells. , 1996, The New England journal of medicine.

[32]  M. Petri.  Biochemical characterization of ADP-ribose polymer metabolism in SLE. , 1996 .

[33]  D. Gladman,et al.  Mortality studies in systemic lupus erythematosus. Results from a single center. II. Predictor variables for mortality. , 1995, The Journal of rheumatology.

[34]  P. Poulsen,et al.  Microalbuminuria and Potential Confounders: A review and some observations on variability of urinary albumin excretion , 1995, Diabetes Care.

[35]  V. Salomaa,et al.  Association of fibrinolytic parameters with early atherosclerosis. The ARIC Study. Atherosclerosis Risk in Communities Study. , 1995, Circulation.

[36]  A. Nicolaides,et al.  Carotid intima‐media thickness: correlation with the British Regional Heart Study risk score , 1994, Journal of internal medicine.

[37]  L. Magder,et al.  Effect of prednisone and hydroxychloroquine on coronary artery disease risk factors in systemic lupus erythematosus: a longitudinal data analysis. , 1994, The American journal of medicine.

[38]  Y. Shinohara,et al.  Lipoprotein(a) and Ischemic Cerebrovascular Disease in Young Adults , 1994, Stroke.

[39]  D. Wallace,et al.  The Relevance of Antimalarial Therapy with Regard to Thrombosis, Hypercholesterolemia and Cytokines in SLE , 1993, Lupus.

[40]  R. Zechner,et al.  Interleukin 1α decreases the synthesis and activity of lipoprotein lipase in human adipose tissue , 1993 .

[41]  M. Petri,et al.  Risk factors for coronary artery disease in patients with systemic lupus erythematosus. , 1992, The American journal of medicine.

[42]  R. DeFronzo,et al.  Insulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease , 1991, Diabetes Care.

[43]  F. Violi,et al.  Tissue plasminogen activator inhibitor in patients with systemic lupus erythematosus and thrombosis. , 1990, BMJ.

[44]  M. Blombäck,et al.  PLASMINOGEN ACTIVATOR INHIBITOR IN PLASMA: RISK FACTOR FOR RECURRENT MYOCARDIAL INFARCTION , 1987, The Lancet.

[45]  D. Gladman,et al.  Morbidity in systemic lupus erythematosus. , 1987, The Journal of rheumatology. Supplement.

[46]  V. Armstrong,et al.  The association between serum Lp(a) concentrations and angiographically assessed coronary atherosclerosis. Dependence on serum LDL levels. , 1986, Atherosclerosis.

[47]  N. Morton,et al.  Lp(a) lipoprotein as a risk factor for myocardial infarction. , 1986, JAMA.

[48]  M. Kameyama,et al.  Lp(a) lipoprotein as a risk factor for coronary heart disease and cerebral infarction. , 1986, Atherosclerosis.

[49]  R. Kaslow,et al.  High rate of death caused by systemic lupus erythematosus among U. S. residents of Asian descent. , 1982, Arthritis and rheumatism.

[50]  M. Urowitz,et al.  The bimodal mortality pattern of systemic lupus erythematosus. , 1976, The American journal of medicine.

[51]  J. Balow.  Kidney disease in systemic lupus erythematosus , 2004, Rheumatology International.

[52]  Sabljar-Matovinović Mirjana.  Secondary glomerular diseases , 2003 .

[53]  L. Kuller,et al.  Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus. , 1999, Arthritis and rheumatism.

[54]  M. Kilgore,et al.  Estrogen regulation of adipose tissue lipoprotein lipase--possible mechanism of body fat distribution. , 1998, American journal of obstetrics and gynecology.

[55]  G. Hughes,et al.  Elevated plasma lipoprotein(a) level and its association with impaired fibrinolysis in patients with antiphospholipid syndrome. , 1998, The Journal of rheumatology.

[56]  D. Ramji,et al.  Synergism between interferon gamma and tumour necrosis factor alpha in the regulation of lipoprotein lipase in the macrophage J774.2 cell line. , 1998, Cytokine.

[57]  P. J. Newman,et al.  The biology of PECAM-1. , 1997, The Journal of clinical investigation.

[58]  M. Petri.  Thrombosis and systemic lupus erythematosus: the Hopkins Lupus Cohort perspective. , 1996, Scandinavian journal of rheumatology.

[59]  H. Parving,et al.  Dyslipidaemia and cardiovascular disease in non-insulin-dependent diabetic patient with and without diabetic nephropathy. , 1994, Journal of internal medicine. Supplement.

[60]  D. Wagner.  Cell biology of von Willebrand factor. , 1990, Annual review of cell biology.