Pattern of arterial calcification in patients with systemic lupus erythematosus.

Objective: To evaluate the prevalence and pattern of arterial calcification in patients with asymptomatic systemic lupus erythematosus (SLE) compared with control subjects. SLE patients are prone to adverse cardiovascular events; however, the underlying atherosclerotic process is unknown. Multidetector computed tomography (MDCT) measured arterial calcium score (CS) reflecting underlying atherosclerosis and is closely associated with cardiovascular events.

Methods: Fifty age and sex matched SLE patients and controls were enrolled. All subjects underwent 64 slice MDCT scan to evaluate CS in coronary, carotid arteries and the aorta.

Results: As compared with controls, SLE patients had higher mean CS and prevalence of CS > 0 across all vascular beds. After adjustment for age and sex, SLE patient odds of having CS > 0 in any vascular bed was 33.6 (95% CI: 9.5-165.2) were higher versus patients in the control group, mainly due to more prevalent coronary calcification (OR 30.0, 95% CI: 6.7-203.8). In SLE patients, the most frequent vessel with CS > 0 was coronary (42%) followed by carotid artery (24%). Further, arterial calcification occurred early involving 40% of SLE patients at age < 40 years, with increasing prevalence as age advanced.

Conclusion: Our study confirms that patients with SLE have significantly higher prevalence and extent of systemic arterial calcification compared with age and sex matched controls.