Myocardial perfusion imaging in assessing risk of coronary events in patients with systemic lupus erythematosus

Mandana Nikpour, Dafna D. Gladman, Dominique Ibañez, Ian N. Bruce, Robert J. Burns, Murray B. Urowitz

    Research output: Contribution to journalArticlepeer-review


    Objective. Classic risk factors do not fully account for the increased risk of coronary artery disease (CAD) in systemic lupus erythematosus (SLE), making identification of the subset of patients at risk challenging. In this prospective cohort study we investigated whether myocardial perfusion defects in SLE are predictive of CAD events, independently of traditional Framingham risk factors. Methods.We performed myocardial perfusion imaging in 122 women with SLE who did not have a history of CAD. Patients had clinical and serologic evaluation, and an assessment of cardiac risk factors. They were then followed for the occurrence of CAD events. Cox regression models were used to determine independent predictors of CAD. Results. Forty-six (37.7%) patients had perfusion defects. Median followup was 8.7 years, during which 15 CAD events occurred (1 myocardial infarction, 14 angina). Cox modeling showed that myocardial perfusion defects are strongly predictive of CAD [hazard ratio (HR) 13.0, 95% CI 2.8 to 60.1, p = 0.001]. Although the 10-year Framingham risk score was significantly predictive of CAD (HR 1.8, 95% CI 1.1 to 2.9, p = 0.01), the risk scores in groups with normal and abnormal scans were similar to the "low-risk" general population. Conclusion. In women with SLE, myocardial perfusion defects are strongly and independently predictive of CAD. Our findings suggest that myocardial perfusion imaging to assess risk of future coronary events should be considered in women with SLE. The Journal of Rheumatology Copyright © 2009. All rights reserved.
    Original languageEnglish
    Pages (from-to)288-294
    Number of pages6
    JournalJournal of Rheumatology
    Issue number2
    Publication statusPublished - Feb 2009


    • Coronary artery disease
    • Myocardial infarction
    • Myocardial perfusion imaging
    • Risk assessment
    • Systemic lupus erythematosus
    • Women


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