Predicting Risk of Atherosclerosis in Women with Lupus

McMahonBevra HahnThe risk of atherosclerosis in women with lupus can be predicted using a combination of lab blood tests for novel biological markers (biomarkers), according to LRI-funded research by Drs. Maureen McMahon (left) and Bevra Hahn, (right) University of California, Los Angeles. The combined biomarkers were more accurate than traditional blood tests for heart disease and could be used in the future to determine which lupus patients should receive treatments to prevent heart attacks and stroke. (Arthritis & Rheumatism, September 2013)

The build-up of fatty, cholesterol-laden plaques in arteries, known as atherosclerosis (hardening of the arteries), is more likely in women with lupus and can lead to heart attacks and strokes, major causes of death in lupus patients.

In lupus patients, atherosclerosis (development of plaques in the arteries) cannot be explained by traditional risk factors such as high blood pressure and diabetes; other factors specific to lupus seem to be involved.

Drs. McMahon and Hahn were the first to identify one of those risk factors for plaques – an altered ‘bad’ form of good cholesterol known as pro-inflammatory HDL.  Their LRI-funded research showed that a blood test for this dangerous form of good-cholesterol can identify lupus patients with increased risk of atherosclerosis.

Their new study showed that this blood test is even more accurate when used in a combination of several tests using novel inflammation markers.

Over 200 lupus patients in the Los Angeles area had the combination test followed by an artery ultra-sound two and a half years later, to see if atherosclerosis developed or progressed. Results showed the combination test to be more accurate and sensitive than any individual test in predicting who would develop new or more extensive plaques.

Future studies in other patient populations are needed to confirm the effectiveness of the test to predict atherosclerosis and also heart attack and stroke.

Dr. Hahn noted, “Currently we do not know what treatments can prevent atherosclerosis and life-threatening cardiovascular events in lupus patients. Identifying patients at high risk for atherosclerosis will help design clinical trials to test ways to prevent the disease.”

The research is published in the top-ranking rheumatology journal, Arthritis & Rheumatism.