Clinical subgroup analysis of patients with systemic lupus erythematosus (SLE) (n = 281) and age and sex-matched population controls reveals that accelerated atherosclerosis is mainly confined to a subgroup of patients with SLE and nephritis. The patients with nephritis had significantly more carotid plaques than their respective controls (P = 0.008), which was not the case for the patients with antiphospholipid antibodies or SSA and/or SSB antigens. Plaques occurred twice as often in the patients with nephritis (23%) than in the patients without nephritis (11%, P = 0.038) or in controls (12%, P = 0.035).