Myocardial perfusion and coagulation abnormalities in patients with systemic lupus erythematosus
systemic lupus erythematosus ; myocardial perfusion ; coagulation
Background: Cardiovascular events as the manifestation of accelerated atherosclerosis are frequent cause of death and morbidity in systemic lupus erythematosus (SLE). ft is likely, that inflammation and activated coagulation are the predisposing factors. Myocardial perfusion imaging is one of the recognized techniques to evaluate the risk of acute coronary syndromes. Exploring the relationship between coagulation and myocardial perfusion in SLE patients was the aim of this study. Methods: The study comprised of 30 female SLE patients without symptoms of coronary artery disease. Their age was between 18-50 years (mean 37,3; SD ±9,09), average duration of the disease was 7 years (SD ±4,44) and the course of the disease was stable for at least 3 months. In all patients clinical evaluation, myocardial perfusion imaging and laboratory tests were performed. Myocardial perfusion gated SPECT with MIBI-Tc99m was performed using pharmacological stress test (dipirydamole). Laboratory tests comprised of markers of inflammation (IL-6, CRP, sCD40L), markers of activated coagulation (fibrynogen, D-dimers, TAT complexes), blood count and biochemical tests. Results:· Myocardial perfusion defects were observed in 70% of patients. Levels of CRP, TAT complexes, fibrynogen and D-dimers were higher in the group with perfusion abnormalities than in patients with normal scans (3,0 vs 0,4 mg/l, p<0,001 ; ; 1,59 vs 1,24 ug/l, p<0,01; 3,21 vs 2,66 g/l, p<0,05; 328 vs 181 ug/l, p<0,05 respectively). No differences were found between the groups in terms of age, cardiovascular risk factors, clinical manifestation of SLE, its activity, methods of treatment and immunological profile. Conclusions: Higher levels of inflammatory markers and increased coagulation activity are associated with myocardial perfusion abnormalities in patients with SLE. These mechanisms may increase the risk of cardiovascular events in this population.
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choroby układu krążenia ; immunologia