van Leuven Sander I, van Bon Lenny, Nijveldt Robin, Major Amy S
Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Rheumatol Adv Pract. 2025 Jun 4;9(2):rkaf048. doi: 10.1093/rap/rkaf048. eCollection 2025.
Patients with systemic lupus erythematosus (SLE) have increased risk of developing atherosclerotic cardiovascular disease (ASCVD). This excessive risk starts to accumulate during the earliest stages of SLE. ASCVD in SLE is associated with an adverse outcome. SLE-enhanced atherogenesis is most likely the consequence of a complex interplay between traditional risk factors and chronic auto-immune inflammation. This underscores the importance of conscientious management of traditional risk factors as well as maintaining low SLE disease activity. Shared immune pathways in SLE and ASCVD can affect the vascular biology of the atherosclerotic process in patients with SLE. In this review, we will discuss how the ASCVD risk evolves during the SLE disease course, and we consider whether patients with SLE are prone to developing superficial erosion of atherosclerotic plaques. This is highly relevant as pilot studies in the general population suggest antithrombotic therapy without stenting could be the better therapeutic approach in patients with plaque erosion.
系统性红斑狼疮（SLE）患者发生动脉粥样硬化性心血管疾病（ASCVD）的风险增加。这种额外的风险在SLE的最早阶段就开始累积。SLE中的ASCVD与不良结局相关。SLE增强的动脉粥样硬化形成很可能是传统危险因素与慢性自身免疫炎症之间复杂相互作用的结果。这凸显了认真管理传统危险因素以及维持低SLE疾病活动度的重要性。SLE和ASCVD中共同的免疫途径可影响SLE患者动脉粥样硬化过程的血管生物学。在本综述中，我们将讨论ASCVD风险在SLE病程中如何演变，并且我们考虑SLE患者是否易于发生动脉粥样硬化斑块的浅表糜烂。这具有高度相关性，因为普通人群中的初步研究表明，对于斑块糜烂患者，不进行支架置入的抗血栓治疗可能是更好的治疗方法。
