A5.18Carotid ultrasonography: usefullness to evaluate cardiovascular risk in patients with systemic lupus erythematosus

BackgroundThe frequency of stroke in SLE patients between 18-44 years is 2 times the frequency in general population of the same age and sex. Clinical atherosclerosis is detected in 6%-12% of patients with SLE. Some researchers have suggested that the development of atherosclerosis may be related to the systemic inflammation. The objetive of our study is to assess cardiovascular risk in patients with SLE by measuring carotid intima-media thickness and identifying the presence of plaques.Material and methodsCross-sectional study on a series of 10 SLE patients without dyslipidemia. The presence of plaques and/or an intima-media thickness higher than 0.9 mm, evaluated with a high-resolution B mode ultrasound, reflect high cardiovascular risk.ResultsOf the 10 patients, 8 were women. The mean age was 36 plus or minus 1.2 years and the mean age at diagnosis of the disease 23.2 plus or minus 7.37 years. The patient's characteristics and analytical data are shown in table 1.Abstract A5.18 Table 1Patient's characteristics and analytical dataPatient's characteristicsFreq uencyAnalytical dataValues Major organ involvement 7/10 Total cholesterol 186.71 plus or minus 32.54 DM 0/10 LDL 98.71 plus or minus 15.43 Arterial hypertension 1/10 HDL 85.46 plus or minus 17.60 Previous stroke 1/10 Triglycerides 129.71 plus or minus 25.2 Smoking 2/10 RCP 21.2 plus or minus 4.3 Corticosteroids (mean dosis) 5/10 (7.5 mgr/day) ESR 17.43 plus or minus 7.59 Inmunosupressants 5/10 C3 77.14 plus or minus 27.9 Rituximab 7/10 C4 18.48 plus or minus 4.52 Mean intima-media thickness in the right carotid was 580.72 plus or minus 103.83 mm and in the left 544.76 plus or minus 202.17 mm. Of the 10 patients, 3 had plaques, 2 of them were smokers and had been treated with Rituximab after unsuccessfully treatment with several immunosuppressants.ConclusionsThe 30% of our patients had plaques, even without having classical cardiovascular risk factors. The use of carotid ultrasound may predict cardiovascular events. Carotid study may be considered for assessing the existence of subclinical aterosclerosis in SLE patients and treating with statins when necessary.