Incidence and predictors of aorta calcification in patients with systemic lupus erythematosus

Lupus. 2019 Mar;28(3):275-282. doi: 10.1177/0961203319826689. Epub 2019 Feb 10.

Abstract

Objective: Artery calcification, as subclinical atherosclerosis, is attracting attention. The aim of this study was to determine the prevalence and risk factors of artery calcification in patients with systemic lupus erythematosus.

Methods: 641 patients with systemic lupus erythematosus were enrolled in the study. Demographic, clinical, and laboratory characteristics were collected. Calcification score was quantified from the multi-detector computed tomography scan image using the Agatston Score method.

Results: The total incidence of artery calcification was 25.9% (166/641), of which the percentages of aorta calcium and coronary artery calcification were 23.1% (148/641) and 8.4% (54/641), respectively. In multivariate models, systemic lupus erythematosus patients with artery calcification had longer disease duration than patients without artery calcification ( p < 0.05). Presence of serositis (OR 2.559, 95%CI 1.414-4.632), pneumonia (OR 2.022, 95%CI 1.102-3.711) and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score (OR 1.049, 95%CI 1.004-1.095) were independently associated with increased risk of aorta calcium, while the duration of corticosteroids use (OR 1.039, 95%CI 1.002-1.078) and cyclophosphamide therapy (OR 8.251, 95%CI 2.496-27.279) were independently associated with increased risk of coronary artery calcification in systemic lupus erythematosus patients. In systemic lupus erythematosus patients, aorta calcium was prone to occur at a younger age compared to coronary artery calcification, and aorta calcium score was positively correlated with age.

Conclusions: Systemic lupus erythematosus patients had a much earlier onset and higher incidences of aorta calcium than coronary artery calcification. Presence of serositis, pneumonia, and higher SLEDAI score may predict increased risk of aorta calcium.

Keywords: Aortic artery calcium; coronary artery calcification; multi-detector computed tomography; systemic lupus erythematosus.

MeSH terms

  • Adult
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / pathology*
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / epidemiology*
  • Aortic Valve Stenosis / etiology
  • Calcinosis / diagnostic imaging
  • Calcinosis / epidemiology*
  • Calcinosis / etiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Lupus Erythematosus, Systemic / complications*
  • Male
  • Middle Aged
  • Pneumonia / complications
  • Pneumonia / epidemiology
  • Risk Factors
  • Serositis / complications
  • Serositis / epidemiology
  • Tomography, X-Ray Computed

Supplementary concepts

  • Aortic Valve, Calcification of