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The following is a summary of “Coronary Artery Calcification Progression in Patients With Systemic Lupus Erythematosus,” published in the October 2024 issue of Rheumatology by Ocampo-Torres et al. 

Systemic lupus erythematosus (SLE) increases the risk of coronary artery calcification (CAC). 

Researchers conducted a retrospective study to evaluate the progression of CAC and associated risk factors in a SLE cohort. 

They reevaluated CAC in patients with SLE who were evaluated 9 years earlier with multidetector computed tomography (CT). In addition, over time clinical factors such as disease activity, damage, antiphospholipid syndrome, SLE serology, and cardiovascular (CV) risk factors including hypertension, BMI, Framingham risk score, lipid profile, and menopausal status. 

The results showed that 104 patients from the parent study were included, with most being women (94.2%), having a mean age of 41.0 (SD 8.3) years, and a mean disease duration of 14.8 (SD 2.9) years. CAC was documented in 17 patients (16.3%), with 7 cases from the parent study and 10 as incident cases. The cumulative incidence of CAC was 9%, and the incidence density was 1 per 100 person-years. CAC occurred more frequently in the 30-39 and 40-44 age groups. All patients with previous CAC experienced worsening of their calcium indexes, but none developed clinical CV events. When comparing prevalent CAC cases (n = 17) to those without calcification (n = 87), both groups were similar in traditional CV risk factors, disease duration, Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) area under the curve (AUC), and Systemic Lupus International Collaborating Clinics (SLICC) scores. However, those with CAC were more likely to be postmenopausal and have higher apolipoprotein B (apoB) levels. Additionally, patients with previous CAC had higher apoB levels, SLEDAI-2K AUC scores, and anticardiolipin IgG antibodies than incident cases. 

Investigators observed that CAC in patients with SLE progressed over time but was not linked to adverse CV events during the 9-year follow-up. Higher ApoB levels and postmenopausal status were possibly associated with this progression. 

Source: jrheum.org/content/51/10/991