Coronary artery bypass grafting in patients with systemic lupus erythematosus. Report of 2 cases.

Systemic lupus erythematosus is an autoimmune disease that often involves the cardiovascular system. Coronary artery narrowing in patients with lupus erythematosus is severe, progressive, and related to the duration of the disease rather than to the age of the patient. Steroid use in such patients has improved their life expectancy but seems to be increasing the incidence of coronary involvement. Consequently, a larger number of systemic lupus erythematosus patients may be candidates for myocardial revascularization in the future. We report our experience with myocardial revascularization in 2 women with severe systemic lupus erythematosus, incapacitating angina, and severe obstructive coronary artery disease. One of the women required balloon angioplasty 19 months after coronary artery bypass grafting and remains asymptomatic nearly 3 years later. The other patient is free of symptoms 9 months after surgery. Our results with these 2 patients are encouraging. Long-term follow-up should yield further information regarding the benefits of myocardial revascularization and coronary angioplasty in patients with systemic lupus erythematosus.