Zinglersen Lise, Zinglersen Amanda Hempel, Myhr Katrine Aagaard, Hermansen Marie-Louise, Kofoed Klaus Fuglsang, Fuchs Andreas, Diederichsen Louise P, Jacobsen Søren
Copenhagen Research Center for Autoimmune Connective Tissue Diseases (COPEACT), Copenhagen University Hospital, Rigshospitalet, Denmark.
Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Rheumatol Int. 2025 Jan 13;45(1):26. doi: 10.1007/s00296-025-05785-8.
To investigate if progression of coronary artery calcification (CAC) in patients with systemic lupus erythematosus (SLE) is associated with renal and traditional cardiovascular risk factors as well as incidence of myocardial infarctions. CAC progression was evaluated by cardiac computed tomography (CT) at baseline and after 5 years. Multivariable Poisson regression was applied to investigate associations between CAC progression and baseline values for traditional cardiovascular risk factors, CAC, SLE disease duration, lupus nephritis, and renal function. Regarding renal function, three groups were defined based on eGFR. Further, we analysed association between CAC progression and myocardial infarction during follow-up. Of the 147 SLE patients, 99 had cardiac CT at baseline and 5-year follow-up, with a total of 502 patient-years. At baseline, their median age was 47 years, median SLE disease duration was 14 years, 88% were women, 58% had lupus nephritis, and the median eGFR was 99 mL/min/1.73m. 38/99 (39%) had CAC progression. CAC progression was associated with smoking (ever) (relative risk [RR] 1.69, CI95% 1.19-2.40), SLE disease duration (RR per year 1.03, CI95% 1.01-1.04), and CAC presence (RR 2.52, CI95% 1.68-3.78) at baseline. During follow-up, myocardial infarction occurred in three (7.9%) CAC progressors and in two (3.3%) patients who did not have CAC at any time (RR 2.1, CI95% 0.0-5.5). In this study, progression of CAC was associated with smoking, SLE disease duration and the prior presence of CAC, but it was inconclusive as to associations with renal involvement and incidence of MI.
研究系统性红斑狼疮（SLE）患者冠状动脉钙化（CAC）进展是否与肾脏及传统心血管危险因素以及心肌梗死发生率相关。通过心脏计算机断层扫描（CT）在基线期和5年后评估CAC进展情况。应用多变量泊松回归分析来研究CAC进展与传统心血管危险因素的基线值、CAC、SLE病程、狼疮性肾炎及肾功能之间的关联。关于肾功能，根据估算肾小球滤过率（eGFR）定义了三组。此外，我们分析了随访期间CAC进展与心肌梗死之间的关联。在147例SLE患者中，99例在基线期和5年随访期进行了心脏CT检查，总计502患者年。基线期，他们的中位年龄为47岁，SLE中位病程为14年，88%为女性，58%有狼疮性肾炎，中位eGFR为99 mL/min/1.73m²。38/99（39%）有CAC进展。基线期，CAC进展与吸烟（曾经吸烟）（相对风险[RR] 1.69，95%置信区间[CI] 1.19 - 2.40）、SLE病程（每年RR 1.03，95%CI 1.01 - 1.04）以及CAC存在情况（RR 2.52，95%CI 1.68 - 3.78）相关。随访期间，3例（7.9%）CAC进展者和2例（3.3%）在任何时间均无CAC的患者发生了心肌梗死（RR 2.1，95%CI 0.0 - 5.5）。在本研究中，CAC进展与吸烟、SLE病程及既往CAC存在情况相关，但与肾脏受累及心肌梗死发生率的关联尚无定论。
