LONDON — Patients with systemic lupus erythematosus should be evaluated on an annual basis for cardiovascular risk until such time as specific recommendations are formulated, Heiko Schotte, M.D., said at the Sixth European Lupus Meeting.
Results of procedures that detect coronary insufficiency, surrogates of atherosclerotic burden, and echocardiographic findings are often abnormal in SLE, but evidence to support routine screening is not currently available. “Therefore, based on the recommendations that have been proposed for other conditions associated with cardiovascular disease, we suggest annual assessment of traditional risk factors including diabetes mellitus, dyslipidemia, hypertension, smoking, and family history of premature coronary disease,” Dr. Schotte said in a poster session at the meeting, which was sponsored by the British Society for Rheumatology.
If two or more risk factors are present, an exercise ECG should be done, he said.
The cardiac manifestations of SLE can involve almost all components of the heart—pericardium, myocardium, and valves—and pulmonary hypertension also often develops during the course of disease. Echocardiography also should be done each year to look for any of these abnormalities, even for patients who are asymptomatic, he said.
These recommendations must be confirmed in prospective studies, and should be enlarged to include other SLE-specific risk factors such as antiphospholipid antibodies and long-term corticosteroid therapy, said Dr. Schotte of the department of medicine, Muenster (Germany) University Hospital.