Background/Purpose: Accelerated atherosclerosis leading to premature coronary artery disease remains the major cause of late death in SLE. We sought to characterize noncalcified and calcified plaque lesions in patients with systemic lupus erythematosus and to compare the findings with a group of healthy controls.

Methods: A total of 70 patients who met the ACR or SLICC classification criteria for SLE were included in the study. All patients underwent coronary CT angiography. A total of 100 non-matched healthy controls were included in the study.  Coronary plaque area was measured by manual tracing for the difference between the area within the external elastic membrane and the area of the vessel lumen at the site of maximal luminal narrowing as observed on a cross-sectional coronary CT angiography image.

Results:

Table 1. Mean plaque volume (95% CI, in mm³ ) between study groups at baseline

Table 2.   Mean (SD) of Calcified and Non-calcified Plaque, in each cohort, by age and sex

Conclusion: SLE patients on average have a significantly higher burden of noncalcified plaque (p<0.0001) compared to controls, while surprisingly, the calcified plaque burden is lower (p<0.0001). The limitation of our study is the comparatively older age of the control group as well as the gender discrepancy, with males being predominant among the controls. Nevertheless, this discrepancy even further highlights the burden of high risk noncalcified plaque in SLE.