Division of Rheumatology and Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
J Rheumatol. 2010 Mar;37(3):579-84. doi: 10.3899/jrheum.090824. Epub 2010 Jan 28.
To study noncalcified coronary plaque (NCP) in systemic lupus erythematosus (SLE).
Sixty-four-slice coronary multidetector computed tomography (MDCT) was performed in 39 consecutive patients with SLE. MDCT scans were evaluated semiquantitatively by a radiologist using dedicated software. The presence or absence of NCP in each coronary artery was assessed. Patients with mixed plaque (calcified and noncalcified portions) were included in the NCP group.
The patient group was 90% women, 64% Caucasian, 31% African American, 5% other; mean age 50.5 +/- 9.6 years. Fifty-four percent (21/39) had NCP. Seventy-six percent (16/21) of those with NCP also had coronary calcium (range 0.7 to 1264.1 Agatston units). In univariate analysis, NCP was associated with age (p = 0.01), current nonsteroidal antiinflammatory drug (NSAID) use (p = 0.04), hormone replacement therapy (p = 0.02), current use of immunosuppressive drugs (p = 0.02), current low serum C3 level (p = 0.07), current physician's global assessment of activity (PGA; p = 0.05), and low-density lipoprotein cholesterol (p = 0.04). NCP was not associated with other risk factors for atherosclerosis, including total serum cholesterol, high sensitivity C-reactive protein, and lipoprotein(a).
Unlike coronary calcium, which is not associated with SLE activity measures or with active serologies, NCP is more common in patients with SLE with current, 3-, and 6-month activity by PGA. NCP was also associated with the need for current NSAID or immunosuppressive therapy. NCP is an important part of the total atherosclerotic burden in SLE.
研究系统性红斑狼疮（SLE）患者的非钙化性冠状动脉斑块（NCP）。
对 39 例连续的 SLE 患者进行 64 排冠状动脉多层螺旋 CT（MDCT）检查。使用专门的软件，由放射科医师对 MDCT 扫描进行半定量评估。评估每个冠状动脉是否存在 NCP。将存在混合斑块（钙化和非钙化部分）的患者纳入 NCP 组。
患者组 90%为女性，64%为白种人，31%为非裔美国人，5%为其他种族；平均年龄 50.5±9.6 岁。54%（21/39）有 NCP。21 例 NCP 患者中有 76%（16/21）同时存在冠状动脉钙化（范围 0.7 至 1264.1 阿加斯顿单位）。单因素分析显示，NCP 与年龄（p=0.01）、当前非甾体抗炎药（NSAID）使用（p=0.04）、激素替代疗法（p=0.02）、当前使用免疫抑制剂（p=0.02）、当前血清 C3 水平低（p=0.07）、当前医生总体活动评估（PGA；p=0.05）和低密度脂蛋白胆固醇（p=0.04）有关。NCP 与动脉粥样硬化的其他危险因素无关，包括总胆固醇、高敏 C 反应蛋白和脂蛋白（a）。
与不与 SLE 活动指标或活动血清学相关的冠状动脉钙化不同，NCP 在当前、3 个月和 6 个月 PGA 活动的 SLE 患者中更为常见。NCP 也与当前 NSAID 或免疫抑制剂治疗的需要有关。NCP 是 SLE 患者总动脉粥样硬化负担的重要组成部分。
