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

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

Table 2 Baseline circulating adhesion molecules

Table 3 Imaging marker progression

Table 4 Adhesion molecules regressed against progression in coronary artery calcium score and aorta calcium score

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.