Eder L, Gladman D D, Ibañez D, Urowitz M B
University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toto Western Hospital, Toronto, Ontario, Canada.
University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toto Western Hospital, Toronto, Ontario, Canada
Lupus. 2014 Oct;23(11):1142-8. doi: 10.1177/0961203314537696. Epub 2014 May 29.
The extent of subclinical atherosclerosis can be assessed by ultrasound measurement of carotid intima-media thickness (cIMT) and total plaque area (TPA). We aimed to investigate the correlation between measures of atherosclerosis as documented on imaging studies of the carotid vasculature and clinical coronary artery disease (CAD) in systemic lupus erythematosus (SLE).
The study patients were recruited from the University of Toronto prospective cohort of SLE patients. Patients who had a history of CAD were compared to those without CAD. TPA and cIMT were measured using high-resolution optimized ultrasound systems. Logistic regression models were used to investigate the strength of association between ultrasound measures of atherosclerosis and CAD. The strength of association as expressed by odds ratio (OR) was compared between TPA and cIMT.
A total of 103 SLE patients were analyzed (27 patients with a history of CAD). Carotid IMT correlated only moderately with TPA (r = 0.43, p < 0.001). Both measures were significantly associated with the presence of CAD. However, TPA showed a stronger association than cIMT (OR 9.55 vs. 2.02, respectively). TPA was also more strongly associated with dyslipidemia and hypertension compared to cIMT.
In SLE patients, cIMT correlates only moderately with TPA, suggesting that they measure different phenotypes of atherosclerosis. Carotid TPA correlated better than cIMT with cardiovascular risk factors and CAD, suggesting that it may serve as a better tool for the investigation of atherosclerosis in SLE.
可通过超声测量颈动脉内膜中层厚度（cIMT）和总斑块面积（TPA）来评估亚临床动脉粥样硬化的程度。我们旨在研究颈动脉血管成像研究中记录的动脉粥样硬化指标与系统性红斑狼疮（SLE）患者临床冠状动脉疾病（CAD）之间的相关性。
研究患者来自多伦多大学SLE患者前瞻性队列。将有CAD病史的患者与无CAD病史的患者进行比较。使用高分辨率优化超声系统测量TPA和cIMT。采用逻辑回归模型研究动脉粥样硬化超声测量指标与CAD之间的关联强度。比较TPA和cIMT以比值比（OR）表示的关联强度。
共分析了103例SLE患者（27例有CAD病史）。颈动脉IMT与TPA仅呈中度相关（r = 0.43，p < 0.001）。这两项指标均与CAD的存在显著相关。然而，TPA显示出比cIMT更强的关联（OR分别为9.55和2.02）。与cIMT相比，TPA与血脂异常和高血压的关联也更强。
在SLE患者中，cIMT与TPA仅呈中度相关，表明它们测量的是动脉粥样硬化的不同表型。颈动脉TPA与心血管危险因素和CAD的相关性优于cIMT，表明它可能是研究SLE患者动脉粥样硬化的更好工具。
