Marija Vavlukis*, Daniela Pop-Gjorcevab, Lidija Poposka, Emilija Sandevska and Sasko Kedev Pages 3221 - 3228 ( 8 )
Background: Accelerated atherosclerosis is widely present in patients with systemic lupus erythematosus.
Objective: The aim of this review was to analyze the relationship between systemic lupus erythematosus and cardiovascular diseases, with the emphasis on acute myocardial infarction.
Methods: We conducted a literature review through PubMed and Cochrane, using keywords: SLE, atherosclerosis, atherothrombosis, coronary artery disease, myocardial infarction, prognosis, sex specifics.
Results: Various molecular mechanisms triggered by infection/inflammation are responsible for endothelial dysfunction and the development of atherosclerosis at an earlier age. A contributing factor is the cumulative effect of traditional cardiovascular risk factors interaction with disease-related characteristics. Myocardial infarction rates are 2- to 10-fold higher compared to the general population. Young women have the highest relative risk, however, men carry at least 3-fold higher risk than women. Coronary involvement varies from normal coronary artery with thrombosis, coronary microartery vasculitis, coronary arteritis, and coronary atherosclerosis. Typical clinical presentation is observed in men and older women, while atypical is more frequent in young women. Treatment is guided by the underlying mechanism, engaging invasive procedures alone, or accompanied with immunosuppressive and/or anti-inflammatory therapy. There are significant gender differences in pathophysiology and clinical presentation. However, they receive the same therapeutic treatments.
Conclusion: Systemic lupus erythematosus is a major contributor to atherosclerotic and non-atherosclerotic mechanisms involved in the development of myocardial infarction, which should be taken into account during therapeutic treatment. Although systemic lupus erythematosus per se is a “female” disease, males are at increased cardiovascular risk and worse outcomes.
Systemic lupus erythematosus, atherosclerosis, atherothrombosis, coronary artery disease, myocardial infarction, prevalence, outcome, sex-specific risk profile.
University Clinic for Cardiology, Medical Faculty, Ss’ Cyril and Methodius University, Skopje, Institute for Pathophysiology and Nuclear Medicine, Medical Faculty, Ss’ Cyril and Methodius University, Skopje, University Clinic for Cardiology, Medical Faculty, Ss’ Cyril and Methodius University, Skopje, University Clinic for Rheumatology, Medical Faculty, Ss’ Cyril and Methodius University, Skopje, University Clinic for Cardiology, Medical Faculty, Ss’ Cyril and Methodius University, Skopje