Morbilidad cardiovascular y evaluación de aterosclerosis en pacientes con lupus eritematoso sistémico

Zoila Marlene Guibert Toledano, Gil Alberto Reyes Llerena, Yanileydys Hernández Muñiz, Dayana Ugarte Moreno, Yaisel Miñoso Arafi

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Resumen

Los pacientes con diagnóstico de lupus eritematoso sistémico, tienen un mayor riesgo de presentar enfermedad cardiovascular. La prevalencia incrementada de aterosclerosis en pacientes con lupus eritematoso sistémico constituye una de las explicaciones a esta problemática.
Objetivos: determinar la presencia de aterosclerosis subclínica y posible presencia de factores de riesgo tradicionales para aterosclerosis en pacientes con lupus eritematoso sistémico.
Métodos: Se realizó un estudio bicéntrico, prospectivo y descriptivo de casos y controles, de pacientes con diagnóstico de lupus eritematoso sistémico, durante un periodo de dos años (entre Julio del 2010 a Julio del 2012). El estudio incluyó 62 enfermos con lupus eritematoso sistémicoS y 60 controles, de ellos, 57 sexo femenino con LES (91,9 %) y 5 pacientes masculinos (8,1 %). Asimismo, hubo 54 controles del sexo femenino (90,0 %) y 6 del sexo masculino (10,0 %). La media de edad en el grupo de pacientes con lupus eritematoso sistémico y grupo control fue 40.9 años y 40.4 años, respectivamente, predominando, en ambos casos, el rango entre 35-44 años.
Resultados: se observó placa ateromatosa en 22 enfermos (35.5 %), de los cuales 14% tuvo algún evento coronario. De los 10 controles con placa, sólo uno tuvo enfermedad arterial coronaria (EAC) (10 %). Los factores de riesgo tradicionales que mostraron asociación con la presencia de placa en pacientes con lupus eritematoso sistémico fueron: hipertensión arterial (HTA) (p=0.003) y dislipidemia; hipercolesterolemia (p=0,038).
Conclusión: La frecuencia de aterosclerosis subclínica y sintomática fue superior en enfermos con lupus eritematoso sistémico comparados con controles. Los factores de riesgo tradicionales que mostraron asociación con la presencia de placa en pacientes con lupus eritematoso sistémico fueron: hipertensión arterial e hipercolesterolemia.

Palabras clave

lupus eritematoso sistémico; aterosclerosis subclínica; aterosclerosis sintomática; enfermedad arterial coronaria

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