Value of carotid plaque detection in prediction of subclinical coronary affection in sle patients

الملخص EN

Objective: The aim of this study was to detect early atherosclerotic changes in SLE patients and its correlation with subclinical coronary events by the use of 2-D ultrasound, which may be helpful in prevention and early treatment.

Methodology: This study was conducted on 33 female systemic lupus erythematosus patients and 10 healthy age and sex matched subjects who served as control.

They were subjected to 2-D ultrasound examination of carotid arteries and carotid plaque index was estimated.

Also, the intimal-medial wall thickness was measured.

Patients with positive carotid plaques were examined further for coronary affection using thaluim scintigraphy.

The lipid profile and atherosclerotic risk ratio were estimated and all the parameters of the patients were correlated.

Results: Eleven of these patients showed the presence of carotid plaques, eight of them show coronary artery affection.

The carotid plaque index correlate positively with age of patients (r=0.72) and the traditional atherosclerotic risk factors as serum cholesterol (r=0.58), serum triglyceride (r=0.53), body mass index (r=0.433), systolic pressure (r=0.35) and diastolic blood pressure (r=0.45) and treatment with corticosteroids.

The mean intimal-medial wall thickness (IMT) of carotid artery in SLE patients was (0.82±0.8mm) higher than those of normal control (0.67±0.4) but was not statistically significant.

Patients with coronary affection had a statistically significant higher values of mean (IMT) (0.63±0.08mm) than those without coronary affection (0.61±0.088mm) (P<0.05).

Conclusion: 2-D ultrasound is a useful non invasive, valid and reliable technique for examination of carotid arteries.

Measurements of carotid plaque index and intimal-medial thickness (IMT) could be used as a detector of the early stages and the follow up of atherosclerosis.

Also, it points to the possible occurrence of coronary events in SLE patients.