Profile of Cardiovascular Risk Factors in Patients with Systemic Lupus Erythematosus: the CArdiovascular Risk Assessment STudy in Lupus Erythematosus (CASTLE SLE) Study // Die CASTLE-SLE-Studie

Introduction and objectives: Patients with systemic lupus erythematosus (SLE) are at increased risk of developing cardiovascular disease. Renal disease in particular represents an additional risk factor. This study sought to characterize cardiovascular markers and clinical findings potentially correlated with increased cardiovascular risk in patients with SLE with or without nephritis. Methods: Consecutive patients with SLE, but without known cardiovascular disease underwent detailed cardiovascular examinations and laboratory tests. SLE patients were stratified according to renal involvement. A matched group of patients with non-autoimmune renal disease were used as control. Results: There were no differences regarding baseline characteristics between the three groups. Patients with SLE were less likely to exercise to a high maximal workload than matched controls. They had less overall exercise capacity, less workload, less bicycle exercise time and achieved less metabolic equivalent of task. SLE patients had higher LDL cholesterol, higher diastolic blood pressures at rest and during exercise and higher triglycerides if nephritis was present. They had also more often arterial hypertension than controls. SLE patients with renal impairment had higher LDL and total cholesterol levels than SLE patients without renal disease. Conclusions: We identified higher LDL and total cholesterol levels among SLE patients with nephritis. SLE patients had in general more often arterial hypertension and particularly higher diastolic blood pressure. Despite the presence of these risk factors we did not detect manifest cardiovascular disease in this small cohort of asymptomatic patients. Further investigations and larger populations are necessary to establish significance of their role for these patients.