Clinical Study Of Systemic Lupus Erythematosus Combined With Coronary Heart Disease

Background:Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease, often involving multiple systems.According to home and abroad studies in recent years, coronary artery disease (CAD) in SLE patients has high incidence, early age of onset, and sever coronary artery lesions.The traditional risk factors cannot fully account for the excess risk of CAD in patients with SLE. SLE itself may be an independent risk factor of CAD.Purpose:The aim of this study was to analyze the clinical characteristics of SLE patients with CAD, to improve the clinical practice and recognition.Methods:According to Fuwai hospital electronic medical record system, we retrospectively analyze a total of 22 SLE patients with CAD (case group) from March 2002 to March 2014, and randomly matched 88 CAD patients (control group). Telephone follow-up of the two groups was conducted. Clinical data was statistical analyzed between the two groups.Results:The proportion of old myocardial infarction (OMI) (p=0.015), hypercholesterolemia (p=0.012), and high CRP level (p=0.016) in the case group were significantly higher than the control group. Left ventricular ejection fraction (LVEF) of the case group was significantly lower than the control group (p=0.011). Serum total cholesterol (TC) (p=0.022), proteinuria (p=0.011) were significantly higher in SLE patients with CAD than CAD patients. Coronary angiography (CAG) showed more multi-vessel lesions [(18/22) vs (47/88), p=0.015] and complete vascular occlusion lesions[(9/22) vs (13/88), p=0.006] in the case group than the control group. The case group had higher mortality than the control group (p=0.029). The cases’ number of readmission (p=0.032) and the average number of readmission (p=0.002) of the case group were more than the control group. The case group had less usage of statins than the control group (p=0.035).Conclusions:SLE patients with CAD patients have more extensive and occlusive coronary artery lesions, and are more frequently combined with heart pump function decline, multiple systems involved and increased number of readmission than CAD patients. SLE itself may be an independent risk factor affecting the severity of CAD. The reduce use of statins may be an independent predictor affecting the readmission of SLE patients with CAD.