Rheumatology Advance Access originally published online on March 27, 2008
Rheumatology 2008 47(5):684-689; doi:10.1093/rheumatology/ken124
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Arteriosclerosis obliterans associated with anti-cardiolipin antibody / β2-glycoprotein I antibodies as a strong risk factor for ischaemic heart disease in patients with systemic lupus erythematosus
1Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Osaka, 2Division of Biomedical Informatics, Course of Health Science, Osaka University Graduate School of Medicine, Suita, 3Department of Health Science, Faculty of Health Science for Welfare, Kansai University of Welfare Science, Kashihara, 4Department of Physiology, Osaka City University Graduate School of Medicine, Abeno-ku and 5Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Correspondence to: J. Nojima, Laboratory for Clinical Investigation, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. E-mail: nojima{at}hp-lab.med.osaka-u.ac.jp
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Abstract |
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Objective. The main objective of this study was to clarify the role of aPLs in the pathogenesis of arteriosclerosis obliterans (ASO), ischaemic heart disease (IHD) and cerebral vascular disorder (CVD) in patients with SLE.
Methods. We evaluated 155 patients with SLE by using objective tests for diagnosing ASO, IHD and CVD and laboratory tests including ELISA for aCL/β2-glycoprotein I antibodies (aCL/β2-GPI) and anti-phosphatidylserine/prothrombin antibodies (anti-PS/PT).
Results. Twenty-five (16.1%) of the 155 SLE patients were diagnosed with ASO. Both aCL/β2-GPI and anti-PS/PT levels were significantly higher in SLE patients with ASO (mean ± S.E., 104.3 ± 38.8 U/ml for aCL/β2-GPI, P < 0.01; 72.6 ± 48.9 U/ml for anti-PS/PT, P < 0.05) than in SLE patients without ASO (22.8 ± 9.9 U/ml for aCL/β2-GPI; 18.3 ± 4.4 U/ml for anti-PS/PT). Multivariate logistic analysis including aCL/β2-GPI, anti-PS/PT and traditional risk factors (hypercholesterolaemia, hypertension and diabetes mellitus) confirmed that the presence of aCL/β2-GPI was the most significant risk factor for ASO in SLE patients [odds ratio (OR) 3.45; 95% CI 1.40, 8.56; P < 0.01]. Furthermore, the prevalence of ASO was associated strongly with IHD (OR 11.8; 95% CI 3.45, 40.1; P < 0.0001) but not CVD (OR 1.84; 95% CI 0.65, 5.21; P = 0.25).
Conclusions. The presence of aCL/β2-GPI contributes to the risk of development of ASO, which may represent an important mechanism for the pathogenesis of IHD in patients with SLE.
KEY WORDS: Systemic lupus erythematosus, Anti-phospholipid antibodies, Arteriosclerosis obliterans, Ischaemic heart disease, Cerebral vascular disorder
Submitted 12 December 2007;
revised version accepted 22 February 2008.
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