This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This single-site, investigator-initiated study will address both fundamental and novel epidemiological questions about the prevalence of and risk factors for subclinical coronary artery disease (CAD) in systemic lupus erythematosus patients (SLE). Multi-slice spiral EKG-gated computed tomography (MSCT) will be utilized to identify and quantify coronary calcification, a marker of atherosclerotic burden. The ultimate goal is to design interventions that will decrease the morbidity and mortality of CAD in patients with rheumatic disease. Potential differences in coronary artery calcification (CAC) in African-American (AA) as compared to Caucasian (Cauc) SLE patients, will be identified so that in future studies appropriate screening and intervention studies appropriate for each ethnic group can be designed. The hypotheses of the study are: 1) CAC will be higher in SLE patients compared to controls; 2) in SLE patients, CAC will be more strongly associated with markers of inflammation and immune dysregulation than with traditional CAD risk factors; 3) the degree of CAC in SLE patients will be associated with the severity of SLE and with corticosteroid therapy; and 4) CAC will be higher in AA SLE patients than Cauc SLE patients and AA controls.
The specific aims are: 1) Compare the prevalence and degree of CAC in SLE patients compared to age, sex, and race-matched controls utilizing MSCT; 2) Examine the strength of the relationships between traditional markers, as well as nontraditional markers, with abnormal CAC scores in SLE patients compared to controls; 3) Characterize the associations between CAC scores and SLE manifestations and/or corticosteroid treatment in SLE patients; and 4) Assess differences in the prevalence of abnormal CAC scores in African-American (AA) SLE patients as compared to AA controls and non-AA SLE patients and to determine if CAC occurs at younger ages in AA SLE as compared to non-AA SLE patients. Study procedures include physical examination, interview, chart review, questionnaires, body mass index, waist/hip measurements, blood samples, and MSCT (no contrast). 334 subjects age 30-75 will be enrolled (167 SLE patients/167 controls) over 3 years.
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