Staff View: Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient

Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient

Introduction: Patients with systemic lupus erythematosus, particularly with lupus nephritis (LN), are at risk of premature cardiovascular (CV) disease. Objective: To determine the association between immunosuppressive medications, traditional CV risk factors and carotid intima media thickness (CIMT)...

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Main Authors:	B. B., Hamidon,, M. T., Azmi,, M. S., Mohd Shahrir,
Format:	Article
Language:	en_US
Published:	Sage Publications Ltd 2015
Subjects:	Carotid Media Intimal Thickness (CIMT) Cyclosporine A Lupus Nephritis Traditional Cardiovascular Risk Factors
Online Access:	http://ddms.usim.edu.my/handle/123456789/8467
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spelling	my.usim-84672017-02-23T03:03:23Z Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient B. B., Hamidon, M. T., Azmi, M. S., Mohd Shahrir, Carotid Media Intimal Thickness (CIMT) Cyclosporine A Lupus Nephritis Traditional Cardiovascular Risk Factors Introduction: Patients with systemic lupus erythematosus, particularly with lupus nephritis (LN), are at risk of premature cardiovascular (CV) disease. Objective: To determine the association between immunosuppressive medications, traditional CV risk factors and carotid intima media thickness (CIMT) among patients with LN. Methodology: This was a cross-sectional study in which consecutive LN patients attending the Nephrology/SLE Clinic were evaluated for traditional CV risk factors. Detailed information on their treatment was obtained from their medical records. CIMT, an excellent marker of subclinical atherosclerosis, was measured by B Mode carotid ultrasound. Results: A total of 82 patients with LN with a mean age of 33.9 +/- 9.8 years were recruited. More than half had hypertension (n = 55, 67.1%) and dyslipidemia (n = 43, 52.4%) as traditional CV risks. Longer history and higher cumulative dose of corticosteroids were associated with hypertension, but use of intravenous methylprednisolone was associated with lower systolic and diastolic blood pressure and lower serum total cholesterol and triglyceride levels (p < 0.05 each). Hydroxychloroquine use was associated with lower total serum cholesterol and serum low-density lipoprotein levels (p < 0.05). Although the use of cyclosporine A (CyA) was associated with hypertension (p < 0.05), those who received a lower cumulative dose of CyA had thicker CIMT (r(s) = -0.33, p = 0.01) and CyA use remained an independent predictor of CIMT during linear regression analysis. There were no associations between CIMT and cumulative dose and duration of steroids, hydroxychloroquine, azathioprine, mycophenolic acid and cyclophosphamide. Conclusion: Aggressive treatment of severe LN and the use of CyA as a steroid-sparing agent may have protective effects against premature atherosclerosis. Lupus (2011) 20, 1260-1266. 2015-06-22T01:45:52Z 2015-06-22T01:45:52Z 2011 Article 0961-2033 http://ddms.usim.edu.my/handle/123456789/8467 en_US Sage Publications Ltd
institution	Universiti Sains Islam Malaysia
building	USIM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universit Sains Islam i Malaysia
content_source	USIM Institutional Repository
url_provider	http://ddms.usim.edu.my/
language	en_US
topic	Carotid Media Intimal Thickness (CIMT) Cyclosporine A Lupus Nephritis Traditional Cardiovascular Risk Factors
spellingShingle	Carotid Media Intimal Thickness (CIMT) Cyclosporine A Lupus Nephritis Traditional Cardiovascular Risk Factors B. B., Hamidon, M. T., Azmi, M. S., Mohd Shahrir, Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient
description	Introduction: Patients with systemic lupus erythematosus, particularly with lupus nephritis (LN), are at risk of premature cardiovascular (CV) disease. Objective: To determine the association between immunosuppressive medications, traditional CV risk factors and carotid intima media thickness (CIMT) among patients with LN. Methodology: This was a cross-sectional study in which consecutive LN patients attending the Nephrology/SLE Clinic were evaluated for traditional CV risk factors. Detailed information on their treatment was obtained from their medical records. CIMT, an excellent marker of subclinical atherosclerosis, was measured by B Mode carotid ultrasound. Results: A total of 82 patients with LN with a mean age of 33.9 +/- 9.8 years were recruited. More than half had hypertension (n = 55, 67.1%) and dyslipidemia (n = 43, 52.4%) as traditional CV risks. Longer history and higher cumulative dose of corticosteroids were associated with hypertension, but use of intravenous methylprednisolone was associated with lower systolic and diastolic blood pressure and lower serum total cholesterol and triglyceride levels (p < 0.05 each). Hydroxychloroquine use was associated with lower total serum cholesterol and serum low-density lipoprotein levels (p < 0.05). Although the use of cyclosporine A (CyA) was associated with hypertension (p < 0.05), those who received a lower cumulative dose of CyA had thicker CIMT (r(s) = -0.33, p = 0.01) and CyA use remained an independent predictor of CIMT during linear regression analysis. There were no associations between CIMT and cumulative dose and duration of steroids, hydroxychloroquine, azathioprine, mycophenolic acid and cyclophosphamide. Conclusion: Aggressive treatment of severe LN and the use of CyA as a steroid-sparing agent may have protective effects against premature atherosclerosis. Lupus (2011) 20, 1260-1266.
format	Article
author	B. B., Hamidon, M. T., Azmi, M. S., Mohd Shahrir,
author_facet	B. B., Hamidon, M. T., Azmi, M. S., Mohd Shahrir,
author_sort	B. B., Hamidon,
title	Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient
title_short	Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient
title_full	Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient
title_fullStr	Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient
title_full_unstemmed	Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient
title_sort	implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient
publisher	Sage Publications Ltd
publishDate	2015
url	http://ddms.usim.edu.my/handle/123456789/8467
_version_	1645152422868287488
score	13.211869

Implications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patient

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