Is there a 'window of opportunity' for intervention to reduce risk of coronary artery disease in SLE?

Abstract

Patients with systemic lupus erythematosus (SLE) have a substantially enhanced risk for cardiovascular complications, especially coronary artery disease (CAD). Evidence from a recent study by Urowitz et al. indicates that the incidence not only of classic CAD risk factors but also of nontraditional CAD risk factors increases within the first 3 years after onset of SLE. The data indicate that patients with SLE require careful management of hypertension and hypercholesterolemia, smoking cessation, and increased physical activity in order to reduce the risk of CAD. Intensive immune intervention is likely to be related to reduction of risk from nontraditional CAD risk factors, but it is not known if this treatment approach also affects classic CAD risk factors. Although established in patients with rheumatoid arthritis in recent years, the effect of immune intervention on classic risk factors for CAD needs to be evaluated in patients with SLE, through either clinical studies or international registries.