Speaker: Date: Topic
George Stojan, MD
June 25, 2014
Atherosclerosis in Systemic Lupus
Responsibility for Content
The WebEx video, PowerPoint presentation, take-away points and article links were sent by the Medical Library and the CME Committee.
Diane E. Young, Information Specialist
To Obtain Other Articles Cited
If you wish to obtain any other articles cited in the presentation, please contact Diane Young.
Take-Away Points of the Presentation
Accelerated atherosclerosis and its long term sequelae are the major causes of late mortality in SLE.
Treatment strategies include an aggressive approach in therapy of traditional cardiovascular risk factors with targets equivalent to the ones used for established CVD.
Smoking inhibits the effect of the antimalarials and should be immediately addressed.
In the absence of contraindications, hydroxychloroquine should be used in EVERY patient.
Despite the negative results of the LAPS trial, statins remain the mainstay of treatment of hyperlipidemia, while fish oil and niacin use are discouraged.
ACE inhibitors should be used as first line agents for treatment of hypertension to a goal of less than 120mmHg systolic.
Aspirin should be used in any patient with SLE who has a history of CVD, positive antiphospholipid antibodies or lupus anticoagulant, history of hypertension, diabetes mellitus, hypercholesterolemia and a history of smoking.
Despite the lack of conclusive benefit, the treatment of vitamin D deficiency and hyperhomocysteinemia is encouraged.
Links to Articles Cited in the Presentation
- Chiu C-C: Increased risk of ischemic stroke in patients with SLE: a nationwide population-based stud
- Gustafsson JT: Risk factors for cardiovascular mortality in patients with SLE: a prospective cohort
- Jewell ML: Patients with cutaneous lupus erythematosus who smoke are less responsive to antimalarial
- Magder L: Incidence of and risk factors for adverse cardiovascular events among patients with SLE. A
- Navarra SV: Efficacy and safety of belimumab in patients with active SLE: a randomised, placebo-cont
- Petri M et al: Lupus Atherosclerosis Prevention Study (LAPS). Ann Rheum Dis 2011;70(5):760-5.
- Ravenell RL: Premature atherosclerosis is associated with hypovitaminosis D and ACE inhibitor non-us
- Ridker PM: Interleukin-1Beta inhibition and the prevention of recurrent cardiovascular events: ratio
- Ruiz-Irastorza et al: Effect of antimalarials on thrombosis and survival in patients with SLE. Lupus
- Stojan G: Atherosclerosis in systemic lupus erythematosus. J Cardiovasc Pharmacol 2013;62(3):255-62.
- Von Feldt: Homocysteine levels and disease duration independently correlate with coronary artery cal