Feb. 04, 2014

Test Panel Found Effective in Predicting Risk of Atherosclerosis in Women with Lupus

Will provide doctors with a valuable tool to help prevent a life-threatening complication of lupus.

A combination of tests that measures four biomarkers for inflammation and two traditional cardiac risk factors has been found to be better at predicting future development of atherosclerosis in people with lupus than did any individual test or risk factor for heart disease. This finding is important because people with lupus are at increased risk for heart disease, a leading cause of death and disability among this group.

Coronary arteries move blood to and from the heart. Over time, fatty molecules and other materials can attach to the walls of blood vessels, forming plaque that can restrict blood flow.  This condition is called atherosclerosis.  Doctors need to be able to identify people who are at risk for developing atherosclerosis so they can provide treatment that can prevent this serious complication. 

Dr. Maureen McMahon of the University of California, Los Angeles Medical Center led the team of investigators that examined several biomarkers for atherosclerosis. A biomarker can be a gene, protein, chemical, or substance that indicates a certain biological state of the body and can be measured and evaluated.  Dr. McMahon’s research team theorized that, in combination with more traditional risk factors for heart disease, certain biomarkers can be used to create a risk profile that would better predict atherosclerosis in people with lupus.

They studied a group of 210 patients with lupus and a group of 100 age-matched healthy individuals. All participants were women who provided blood samples, underwent an ultrasound examination of their arteries, and completed a set of questionnaires on traditional risk factors. Using ultrasound, the investigators measured the buildup of plaque inside blood vessels and the thickness of the inner lining of arteries of participants at the beginning of the study and at 24 months and 36 months. 

After analysis, the investigators found that the PREDICTS panel, comprised of four biomarkers that measure inflammation, and two traditional cardiac risk factors, age and history of diabetes, were the most effective combination to predict the risk of developing atherosclerosis among this group of patients.

Since the participants were only from the Los Angeles area, the investigators cautioned that additional tests are needed to ensure the panel can be effective for participants in other areas. In addition, this study excluded patients who had lupus-related kidney disease and were taking statins, so additional tests are needed to determine whether the panel will apply to these groups of patients as well.

While it will be a few years before the PREDICTS test is commercially available, it promises to provide a valuable screening tool that doctors can use to identify people with lupus who are at risk for developing a common but serious complication of lupus.

A Panel of Biomarkers is Associated with Increased Risk of the Presence and Progression of Atherosclerosis in Women with Systemic Lupus Erythematosus

Arthritis Rheum. 2013 Sep 24. doi: 10.1002/art.38204. [Epub ahead of print]

McMahon M, Skaggs BJ, Grossman J, Sahakian L, Fitzgerald J, Wong WK, Lourenco E, Ragavendra N, Charles-Schoeman C, Gorn A, Karpouzas G, Taylor M, Watson K, Weisman M, Wallace DJ, Hahn BH.

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