Qian Geng, Wang Zhi-feng, Liu Hong-bin, Chen Yun-dai
Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2012 May;40(5):378-81.
To analyze the clinical characteristics of patients with systemic lupus erythematosus (SLE) and coronary artery disease (CAD).
Clinical data of 3911 SLE patients were retrospectively analyzed and CAD was diagnosed by coronary angiography in 26 (0.7%) SLE patients (10 stable angina pectoris, 5 unstable angina pectoris, 8 STEMI and 3 non-STEMI). The tradition risk factors, first onset of cardiac events, blood biochemistry index, treatment and activity of SLE, coronary angiographic features were compared with 552 CAD patients without SLE.
Compared with CAD patients without SLE, CAD patients with SLE were younger [(50.4 ± 15.2) years vs. (60.6 ± 11.6) years, P < 0.01], the mean number per patient of Framingham tradition risk factors was less (1.11 ± 1.18 vs. 2.50 ± 1.28, P < 0.05). CAD patients with SLE were prone to premature coronary artery disease [76.9% (20/26)], and ACS was the most common manifestation in SLE patients with premature coronary artery disease [65.0% (13/20)], the duration of steroid use was significantly longer [24.00 (3.75, 57.00) months vs. 1.00 (0.00, 2.00) months, P < 0.05] and 24 hours total urine protein [(1.93 ± 1.97) g vs. (0.76 ± 0.75) g, P < 0.05] was significantly higher in the ACS patients with SLE than non-ACS patients with SLE. Coronary stenosis was evidenced in most of the SLE patients with CAD [76.9% (20/26)] and incidence of coronary thrombotic occlusion was significantly higher in SLE patients with CAD than CAD patients without SLE [30.8% (8/26) vs. 11.8% (65/552), P < 0.05].
The incidence of CAD in SLE patients is low and the major form of CAD in SLE patients is premature coronary artery disease and mostly induced by coronary thrombotic occlusion.
分析系统性红斑狼疮（SLE）合并冠状动脉疾病（CAD）患者的临床特征。
回顾性分析3911例SLE患者的临床资料，26例（0.7%）SLE患者经冠状动脉造影诊断为CAD（10例稳定型心绞痛、5例不稳定型心绞痛、8例ST段抬高型心肌梗死和3例非ST段抬高型心肌梗死）。将传统危险因素、心脏事件首发情况、血液生化指标、SLE的治疗及活动情况、冠状动脉造影特征与552例无SLE的CAD患者进行比较。
与无SLE的CAD患者相比，SLE合并CAD患者更年轻[（50.4±15.2）岁 vs.（60.6±11.6）岁，P<0.01]，每位患者的弗雷明汉传统危险因素平均数更少（1.11±1.18 vs. 2.50±1.28，P<0.05）。SLE合并CAD患者易患早发性冠状动脉疾病[76.9%（20/26）]，急性冠状动脉综合征（ACS）是SLE合并早发性冠状动脉疾病患者最常见的表现形式[65.0%（13/20）]，SLE合并ACS患者的类固醇使用时间显著更长[24.00（3.75，57.00）个月 vs. 1.00（0.00，2.00）个月，P<0.05]，24小时尿蛋白总量[（1.93±1.97）g vs.（0.76±0.75）g，P<0.05]在SLE合并ACS患者中显著高于SLE合并非ACS患者。大多数SLE合并CAD患者存在冠状动脉狭窄[76.9%（20/26）]，SLE合并CAD患者的冠状动脉血栓闭塞发生率显著高于无SLE的CAD患者[30.8%（8/26） vs. 11.8%（65/552），P<0.05]。
SLE患者CAD的发生率较低，SLE患者CAD的主要形式是早发性冠状动脉疾病，且大多由冠状动脉血栓闭塞引起。
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