Systemic lupus erythematosus combined with acute coronary syndrome: A clinical analysis / 第二军医大学学报

ABSTRACT

Objective To investigate the clinical features and the characteristics of coronary artery lesions of systemic lupus erythematosus (SLE) patients complicated with acute coronary syndrome (ACS), so as to discuss the pathogenesis and clinical characteristics of these patients. Methods We retrospectively reviewed the clinical data of all the in-patients diagnosed with SLE in Changhai Hospital from May 2009 to May 2013, and those combined with ACS as confirmed by coronary angiography (CAG) were taken as the observing group; CAG-confirmed ACS patients at their fist onset without connective tissue disease during Jan. 2013 to May 2013 were taken as controls. The traditional risk factors of coronary heart diseases, age of first occurrence of cardiovascular event, cumulative time of corticosteroid therapy and CAG results were retrospectively analyzed and compared between the two groups. Results Twelve patients were finally enrolled in the observing group and 124 cases in the control group. Compared to the control group, SLE patients had significantly less traditional risk factors ([1.21±0.97] factor per case vs [2.48±1.29] factor per case, P<0.01) and were at a younger age ([45.0±12.8] years vs [57.0±16.4] years,P<0.01) at the first ACS event. CAG showed vascular occlusion, stenosis, aneurysm and acute thrombosis in SLE patients with ACS, with 5 patients having occluded blood vessels (restricted to the left main, left anterior descending artery, circumflex artery and right coronary artery) and all having intracoronary thrombosis. The incidence rate of occluded blood vessels was significantly higher in the observing group compared with that in the control group (41.67% [5/12]) vs 23.39% [29/124], P<0.05). Conclusion SLE patients combined with ACS have less traditional coronary artery disease risks at the first onset of ACS, but at a younger age, with higher incidence of coronary artery occlusion, mostly having intracoronary thrombosis.