Management of cardiovascular disease in patients with systemic lupus erythematosus.

Abstract

INTRODUCTION:

SLE is increasingly recognized as an important risk factor for cardiovascular disease. Premature CAD and several other cardiac manifestations are resulting in significant morbidity and premature death among young and older adults. There is a considerable unmet need for developing specific guidelines toward the primary and secondary prevention of cardiovascular disease in SLE patients.

AREAS COVERED:

The authors describe the prevalence of various cardiovascular manifestations, associated with traditional and lupus-specific risk factors. They summarize the evidence behind various nonpharmacological and pharmacological options such as cardiac medications, antimalarials, anti-inflammatory, and immunosuppressant medications.

EXPERT OPINION:

There is considerable literature claiming that the traditional Framingham score used to calculate the risk in the general population would not clearly predict the 10-year risk among SLE patients as they do not include lupus-specific risk factors such as accelerated inflammation, immunometabolic changes, thrombosis, vasospasm, vasculitis, and endothelial dysfunction into account. Identifying potential risk factors among SLE patients and treating hyperlipidemia regardless of their risk scores may be the first step in reducing mortality. Blocking lupus-specific inflammatory pathways by targeting validated biomarkers of pathogenesis has great future potential and more studies are needed on their cardiovascular benefits.

• Authors: Paramarjan Piranavan, Andras Perl
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 21 Issue 13 Pg. 1617-1628 (Sep 2020) ISSN: 1744-7666 [Electronic] England
• PMID: 32511034 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Inflammatory Agents
• Antimalarials
• Cardiovascular Agents
• Immunosuppressive Agents

Topics

• Aged
• Anti-Inflammatory Agents (therapeutic use)
• Antimalarials (therapeutic use)
• Cardiovascular Agents (therapeutic use)
• Cardiovascular Diseases (drug therapy, etiology, immunology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Inflammation
• Lupus Erythematosus, Systemic (complications, drug therapy, immunology)
• Prevalence
• Risk Factors