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Review
. 2008 Oct;121(10 Suppl 1):S3-8.
doi: 10.1016/j.amjmed.2008.06.010.

Subclinical atherosclerosis in rheumatoid arthritis and systemic lupus erythematosus

Jane E Salmon  1 , Mary J Roman
Affiliations
Review

Subclinical atherosclerosis in rheumatoid arthritis and systemic lupus erythematosus

Jane E Salmon et al. Am J Med. 2008 Oct.

Abstract

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are associated with increased mortality, largely as a consequence of cardiovascular disease. Increased cardiovascular morbidity and mortality in patients with RA and SLE cannot be entirely explained by traditional risk factors, suggesting that the systemic inflammation that characterizes these diseases may accelerate atherosclerosis. We used carotid ultrasonography to investigate the prevalence and correlates to preclinical atherosclerosis in patients with RA and SLE. Because atherosclerosis is a systemic disease, assessment of carotid plaque by ultrasonography provides a robust, direct measure of systemic atherosclerosis. We observed a substantially increased prevalence of carotid plaque in RA and SLE patients compared with age- and sex-matched controls, which remained after adjustment for traditional risk factors. The presence of carotid atherosclerosis was associated with disease duration in both RA and SLE and damage in SLE. These data support the hypothesis that inflammation associated with RA and SLE contributes to accelerated atherosclerosis and argue that RA and SLE disease activity should be more aggressively managed.

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Figures

Figure 1
Figure 1
Comparison of the prevalence of atherosclerotic plaque as assessed by carotid ultrasonography in patients with rheumatoid arthritis (RA), patients with systemic lupus erythematosus (SLE), and matched controls. (Adapted with permission from Ann Intern Med and N Engl J Med.36)
Figure 2
Figure 2
Comparison of the prevalence of atherosclerotic plaque as assessed by carotid ultrasonography in patients with rheumatoid arthritis (RA), patients with systemic lupus erythematosus (SLE), and matched controls, according to age. (Adapted with permission from Ann Intern Med and N Engl J Med.36)
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