Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy.
Department of Autoimmune Diseases, Reference Centre for Systemic Autoimmune Diseases (UEC/CSUR) of the Catalan and Spanish Health Systems-Member of ERNReCONNET, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
Autoimmun Rev. 2024 Oct;23(10):103646. doi: 10.1016/j.autrev.2024.103646. Epub 2024 Sep 23.
Patients with systemic lupus erythematosus (SLE) experience greater cardiovascular morbidity and mortality compared to the general population. It is known that endothelial dysfunction, an early indicator of atherosclerosis development, can arise even without the presence of conventional cardiovascular risk factors. In fact, the risk factors contributing to cardiovascular disease can be classified into traditional risk factors and those uniquely associated with SLE such as disease activity, autoantibodies, etc.Furthermore, the pathogenesis of cardiovascular disease in SLE is linked to the activation of both the innate and adaptive immune systems. Given these findings, it is essential for clinicians to acknowledge the heightened CVD risk in SLE patients, perform comprehensive screenings for cardiovascular risk factors, and implement aggressive treatment strategies for those who exhibit signs of clinical CVD. The aim of this review is to summarize the findings on cardiovascular disease in SLE and to examine potential screening and therapeutic strategies for clinical practice.
系统性红斑狼疮(SLE)患者的心血管发病率和死亡率高于普通人群。众所周知,即使没有传统心血管危险因素的存在,内皮功能障碍(动脉粥样硬化发展的早期指标)也可能发生。事实上,导致心血管疾病的危险因素可分为传统危险因素和与 SLE 特有的因素,如疾病活动度、自身抗体等。此外,SLE 中心血管疾病的发病机制与固有和适应性免疫系统的激活有关。鉴于这些发现,临床医生必须认识到 SLE 患者 CVD 风险增加,对心血管危险因素进行全面筛查,并对有临床 CVD 迹象的患者实施积极的治疗策略。本综述的目的是总结 SLE 中心血管疾病的研究结果,并探讨潜在的筛查和治疗策略用于临床实践。