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Lack of subclinical myocardial ischaemia in Mexican patients with systemic lupus erythematosus without traditional risk factors for coronary artery disease

Systemic Autoimmune Diseases Research Unit, HGR 36, CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Mexico, Rheumatology and Immunology Department, Benemérita Universidad Autónoma de Puebla, School of Medicine, Puebla, Mexico

R.O. Escárcega

Systemic Autoimmune Diseases Research Unit, HGR 36, CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Mexico

J. Pérez-Terrón

Systemic Autoimmune Diseases Research Unit, HGR 36, CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Mexico

A. Ramírez

Cardiology Department, Hospital Betania de Puebla, Puebla, Mexico

M. Muñoz-Guarneros

Rheumatology and Immunology Department, Benemérita Universidad Autónoma de Puebla, School of Medicine, Puebla, Mexico

A. Beltrán

Systemic Autoimmune Diseases Research Unit, HGR 36, CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Mexico

B. Pérez-Cuevas

Rheumatology and Immunology Department, Benemérita Universidad Autónoma de Puebla, School of Medicine, Puebla, Mexico

A. López-Colombo

State Research Department, Instituto Mexicano del Seguro Social, Puebla, Mexico

R. Cervera

Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain, rcervera{at}clinic.ub.es

The objective of this study was to analyse whether patients with systemic lupus erythematosus (SLE) without traditional risk factors for coronary artery disease (CAD) develop subclinical myocardial ischaemia in the first years after diagnosis. A cross-sectional analysis of a cohort of 200 female SLE patients was conducted. We selected those patients who fulfilled the American College of Rheumatology (ACR) SLE criteria and had no traditional risk factors for CAD, including diabetes mellitus, hypertension, obesity, hyperlipidemia, and smoking. After an initial clinical and laboratory examination, patients were evaluated using a baseline echocardiogram and a dobutamine and atropine stress echocardiogram to search for subclinical myocardial ischaemia. Forty-one patients were included in the study. The mean age at the time of the study was 34.5 ± 9.56 years (mean ± SD). The mean age at diagnosis was 30.3 ± 9.39 years. The mean time from diagnosis was 3.9 ± 3.3 years. Baseline disease activity index (MEX-SLEDAI score) showed that 92.6% of patients had disease activity, although most patients had mild activity. A dobutamine and atropine stress echocardiogram was performed in 40 patients. All 40 patients had negative tests for subclinical myocardial ischaemia. Patients without traditional risk factors for CAD do not have an increased risk for subclinical myocardial ischaemia in the first years after diagnosis. A longitudinal follow-up study of these patients is needed to confirm our findings and assess if additional non-traditional risk factors for CAD increase the risk for myocardial ischaemia. Lupus (2007) 16, 298—301.

Key Words: atherosclerosis • stress echocardiogram • subclinical coronary artery disease • systemic lupus erythematosus

Lupus, Vol. 16, No. 4, 298-301 (2007)
DOI: 10.1177/0961203307076519


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