Volume 14 Supplement 3

Lupus 2012: New targets, new approaches

Open Access

Soluble E-selectin may predict progression of subclinical atherosclerosis, as measured by coronary artery calcium score and aorta calcium score, in women with systemic lupus erythematosus

  • A Lertratanakul1,
  • P Wu1,
  • A Dyer1,
  • W Pearce1,
  • G Kondos2,
  • D Edmundowicz3,
  • J Carr1 and
  • R Ramsey-Goldman1
Arthritis Research & Therapy201214(Suppl 3):A21

DOI: 10.1186/ar3955

Published: 27 September 2012

Background

Women with systemic lupus erythematosus (SLE) have increased rates of subclinical atherosclerosis and cardiovascular (CV) events [1, 2]. Circulating adhesion molecules (CAMs) have been associated with subclinical atherosclerosis in SLE patients [3, 4]. We investigated the significance of CAMs in subclinical atherosclerosis progression, as measured by the coronary artery calcium score (CAC) and aorta calcium score (AS) in women with SLE.

Methods

Baseline data collected include demographics and circulating adhesion molecule levels. SLE factors collected included modified SLICC/ACR-DI Damage Index (SDI) (excluding CV outcomes). CAC and AS were measured by electron beam or multidimensional computed tomography at baseline and at one follow-up visit in the Study of Lupus Vascular and Bone Long-Term Endpoints (SOLVABLE). High-risk CAC and AS were defined as CAC >10 and AS >100, respectively. Progression in CAC and AS at follow-up was defined as CAC >10 or AS >100 and >10% increase from baseline. Univariate regression models of CAC and AS with risk factors were examined, and further adjusted for age. CAMs measured were ICAM-1, VCAM-1, soluble E-selectin (sESEL), and CD40L.

Results

Imaging at baseline and follow-up were performed on 142 subjects; baseline AS scans were not performed in 36 subjects (Table 1). Adhesion molecule levels (Table 2) and imaging marker progression (Table 3) results are presented. In age-adjusted models, only sESEL was significantly associated with AS and CAC progression (Table 4).
Table 1

Baseline demographics

 

Age (years)

Disease duration (years)

SLEDAI

SDI

Follow-up time (years)

CAC (n = 142)

43.3 ± 9.9

12.0 ± 8.4

3.8 ± 3.5

1.5 ± 1.6

3.25 ± 0.35

AS (n = 106)

42.2 ± 9.3

12.0 ± 8.5

4.2 ± 3.6

1.6 ± 1.7

3.26 ± 0.35

Data presented as mean ± SD.

Table 2

Baseline circulating adhesion molecules

 

CAC (n= 142)

AS (n= 106)

ICAM-1

279.9 ± 91.34

276.83 ± 85.79

VCAM-1

978.0 ± 352.15

973.69 ± 360.05

sESEL

62.45 ± 28.70

63.81 ± 26.89

CD40 ligand

5,984.11 ± 2,971.26

6,026.31 ± 2,885.9

Data presented as mean ± SD.

Table 3

Imaging marker progression

 

Low risk at baseline

High risk at baseline

 
 

No progression (%)

With progression (%)

With regression (%)

With progression (%)

No progression (%)

Total number with progression (%)

CAC (n = 142)

103 (72.5)

12 (8.5)

2 (1.4)

21 (14.8)

4 (2.8)

33 (23.2)

AS (n = 106)

67 (63.2)

12 (11.3)

4 (3.8)

23 (21.7)

0

35 (33.0)

Table 4

Adhesion molecules regressed against progression in coronary artery calcium score and aorta calcium score

 

CAC progression

AS progression

Risk factor

ORa (95% CI)

ORa (95% CI)

ICAM-1

0.97 (0.63 to 1.45)

1.30 (0.81 to 2.13)

VCAM-1

1.30 (0.69 to 2.41)

1.85 (0.94 to 3.75)

sESEL

1.68 (1.03 to 2.80)

1.94 (1.08 to 3.60)

CD40 ligand

1.01 (0.65 to 1.56)

0.91 (0.56 to 1.44)

a Basis for calculation of OR is 1 SD difference.

Conclusion

A higher level of sESEL is associated with progression in AS and CAC in women with SLE. While previous studies have shown CAMs association with subclinical atherosclerosis [3, 4], these results suggest sESEL may predict progression of subclinical atherosclerosis, as measured by AS and CAC, in women with SLE.

Authors’ Affiliations

(1)
Northwestern University
(2)
University of Illinois Chicago
(3)
Temple University

References

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Copyright

© Lertratanakul et al.; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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