RESUMO
Cardiovascular disease (CVD) is a main cause of death in patients with systemic lupus erythematous (SLE). Algorithms for cardiovascular risk stratification in general population underestimate the risk for CVD in SLE. Our study aimed to determine whether serum high-sensitivity cardiac troponin I (hs-cTnI) might help to identify SLE patients with subclinical atherosclerosis. Arterial stiffness was assessed measuring the carotid-femoral pulse wave velocity (PWV) in 68 SLE women with a normal or almost normal kidney function and in 71 controls of similar characteristics. None of the participants had a history of an overt CVD. Serum hs-cTnI level was measured using the chemiluminescence method. Factors associated with an increased PWV (iPWV) were identified and multivariate analysis was performed. When detectable, patients tended to have had higher hs-cTnI levels than controls [2.9 (2.3-4.0) vs 2.4 (2.2-4.1); p = 0.098] and were more likely to have detectable hs-cTnI [50% vs 28%, odds ratio (OR) 7.0; 95% confidence interval (CI) 0.008-0.013]. Also, patients with iPWV were more likely to have detectable hs-cTnI than those with normal PWV (OR 6.4; 95% CI 0.019-0.026). In the multivariate analysis, the age at SLE diagnosis (OR 1.24; 95% CI 1.04-1.48), systolic blood pressure (OR 1.28; 95% CI 1.10-1.48) and detectable hs-cTnI level (OR 2.04; 95% CI 1.18-3.50) were independently associated with an iPWV. The negative predictive value of having an iPWV with undetectable hs-cTnI levels was 88%. Hs-cTnI may be a useful biomarker for the identification of SLE patients with iPWV as a surrogated marker of subclinical atherosclerosis. Specifically targeted prospective studies are needed to confirm this hypothesis.
Assuntos
Aterosclerose , Doenças Cardiovasculares , Lúpus Eritematoso Sistêmico , Rigidez Vascular , Humanos , Feminino , Troponina I , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Rigidez Vascular/fisiologia , Análise de Onda de Pulso , Biomarcadores , Aterosclerose/diagnóstico , Aterosclerose/complicações , Doenças Cardiovasculares/etiologia , RimRESUMO
Cardiovascular disease is one of the main causes of death in patients with systemic lupus erythematosus (SLE). On the other hand, sclerostin is a reliable and early biomarker of vascular calcification. This study aimed to estimate the association between sclerostin and two markers of cardiovascular risk, carotid atherosclerotic plaque (CP) and carotid-femoral pulse wave velocity (PWV), in women with SLE. The presence of CP (determined by carotid artery ultrasound) and PWV were measured in 68 women with SLE and preserved renal function. None of the participants had a history of cardiovascular disease. Serum levels of sclerostin were determined using the ELISA method. Other factors associated with increased cardiovascular risk were also measured. The association between sclerostin, CP and PWV was assessed using Receiver Operating Characteristic (ROC) curves and multivariate regression models. The area under the ROC curve was 0.785 (95% confidence interval [CI] 0.662-0.871) for CP and 0.834 (95% CI 0.729-0.916) for dichotomized PWV. After adjusting for other cardiovascular risk factors, it was found that a 10-units increase in sclerostin values was associated with a 44% increase in the odds of CP (95% CI 1-105), but no adjusted association was observed between sclerostin and PWV. Predictive models included age (for both outcomes), hypertension, Framingham risk score and C-reactive protein (for PWV), but not sclerostin. Sclerostin is associated with the presence of CP in women with SLE. Further research should confirm its possible role as a biomarker of cardiovascular risk in these patients.
Assuntos
Doenças Cardiovasculares , Lúpus Eritematoso Sistêmico , Humanos , Feminino , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/complicações , Análise de Onda de Pulso , Fatores de Risco , Estudos Transversais , Lúpus Eritematoso Sistêmico/complicações , Biomarcadores , Fatores de Risco de Doenças CardíacasRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Avaliação de Sintomas , Estudos de Coortes , Estudos Retrospectivos , Artralgia/etiologia , Mialgia/etiologia , Fatores de Risco , Dispneia/etiologiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Pirimidinas/efeitos adversos , Antineoplásicos/efeitos adversos , Síndrome Coronariana Aguda/induzido quimicamente , Perna (Membro)/irrigação sanguínea , Perna (Membro)/cirurgia , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Pirimidinas/uso terapêutico , Antineoplásicos/uso terapêutico , Angiografia por Ressonância Magnética , Amputação CirúrgicaRESUMO
The development of cardiovascular disease appears in subjects with several cardiovascular risk factors. However, other agents could be related to the appearance of cardiovascular disease, like chemotherapy drugs. We present a 63 years-old man with very high cardiovascular risk and chronic myeloid leukemia under treatment with nilotinib. Despite a good control of cardiovascular risk factors, he development a severe and accelerated peripheral arterial disease. Peripheral arterial disease occurs in 5-20% patients under treatment with nilotinib and it is more frequently in subjects with several cardiovascular risk factors.
