Blood Test Detects Heart Attack Risk in Lupus Patients

Systemic Lupus Erythematosus (Lupus) is a genetically complex chronic relapsing immune mediated rheumatic disease characterized by inflammation that may affect different tissues, including the skin, joint linings, lungs, kidneys and other organs.

A specific biomarker detected in the blood of lupus patients with no symptoms of cardiovascular disease (CVD), thought to be at low risk of CVD based on traditional risk factors, is associated with the presence of atherosclerosis. Premature CVD is much more common in young premenopausal women with lupus than healthy women of a similar age.

A team of scientists at the Bichat Hospital (Paris, France) used vascular ultrasound, and found 23 out of 63 (36.5%) consecutive lupus patients to have signs of carotid plaques compared to only two out of 18 (11.1%) of a control group. None of these patients nor the controls had symptoms of CVD and they all had a low Framingham risk factor score. Only age and lupus disease status were independently associated with the presence of carotid plaques. The percentage of lupus patients with carotid plaques who had a detectable high-sensitivity cardiac troponin T (HS-cTnT) was 87%; only 42.5% of lupus patients without plaques had a detectable blood level of HS-cTnT. Conversely, 54.5% of lupus patients with a detectable HS-cTnT, but only 11.5% with an undetectable HS-cTnT had a carotid plaque.

The authors concluded that the risk of having fatty deposits (plaques) in the carotid arteries that deliver blood to the brain due to atherosclerosis was increased by a factor of eight times in those lupus patients who had a biomarker known as High Sensitivity Cardiac Troponin T (HS-cTnT) in their blood. Karim Sacre, MD, a professor and lead author of the study, said, “The results of our study raise the possibility that this easily measured biomarker could be introduced into clinical practice as a more reliable way of evaluating CVD risk in lupus patients. This in turn will enable more effective primary prevention measures such as treating abnormally raised blood lipids to be implemented.” The study was presented at the Annual European Congress of Rheumatology (EULAR) held June 14-17, 2017, in Madrid, Spain.

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