Arterial Stiffness in Systemic Lupus Erythematosus and Its Correlation with Disease Severity: A Case Control Study | Chapter 02 | Current Trends in Medicine and Medical Research Vol. 4
Introduction:
Arterial stiffness is
an emerging field
of interest in
atherosclerosis. Patients with
systemic lupus erythematosus (SLE) are predisposed to have premature
atherosclerosis.
Aims:
To compare the arterial stiffness among patients with SLE and non-SLE controls.
The study also compared arterial stiffness among SLE patients in relation to
disease activity (SLEDAI) and end organ damage (SLICC index).
Study
Design: Case control study.
Place
and Duration of Study: Patients attending rheumatology clinic
and those admitted to medical wards of the Internal Medicine and Nephrology
departments of Government Medical College Hospital, Thiruvananthapuram.
Methodology:
53 SLE
patients and 53
non-SLE controls were
studied. Data was
obtained in a structured format. Arterial stiffness
indices were obtained by measuring the brachial ankle pulse wave velocity
(baPWV). The SLEDAI Score and SLICC Damage index were measured in the SLE
group. Age-matched controls were obtained from the general population.
Results:
SLE patients had higher brachial ankle pulse wave velocity (baPWV) than the
control non-SLE population (1194.9 ± 169.6 cm/s vs 1008.5 ± 62.5 cm/s;
p<0.001), Mean arterial stiffness index (ASI) among SLE patients was
significantly higher than that of control (26.2 ± 3.9 mm Hg vs. 23.7 ± 3.7 mm
Hg, p=.001), mean augmentation index(AI) among SLE patients was significantly
higher when compared with the control non-SLE population (13.9± 6.7% vs 6.2 ±
1.7%, p<0.001). Patients with SLE-related
end organ damage
(SLICC index ≥1) had
baPWV elevated over
those with SLICC index=0
(1234.5 ± 181.5
cm/s.1 vs 1124.1
± 121.1 cm/s,
p=.021). No significant
difference was observed between
the mean ASI among the patients with SLICC index ≥1 and those with SLICC=0.
(26.9 ±
4.1 mm Hg vs 24.8
± 3.3 mm
Hg, p=.070), and
mean AI among
SLICC index ≥1 was significantly higher than that of SLICC
index ≥1 (15.6 ± 6.7% vs 11.1 ± 5.8%, p= .017). Patients with high disease
activity (SLEDAI ≥6) had baPWV of 1278.9 ± 131.0 cm/s (95%CI 1229 cm/s.1-1328.7
cm/s) vs
(1093.4 ± 156.5
cm/s; 95% CI
1027.3 cm/s -1159.4 cm/s
p<0.001) when compared
with those having low activity (SLEDAI<6).
Conclusion:
Patients with SLE had increased arterial stiffness. End organ damage and high
disease activity among SLE
patients correlated to
increased arterial stiffness,
and is contributory to an
increased risk of atherosclerosis.
Author(s) Details
Dr. C. Rajasekharan
Department of Medicine,
Medical College Hospital, Thiruvananthapuram, Kerala, 695011, India.
View Volume: https://doi.org/10.9734/bpi/ctmmr/v4
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