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Could a blood test detect the risk of cardiovascular disease in asymptomatic patients with lupus?

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Researchers from Paris Diderot University (Paris, France) have discovered a new biomarker that could have predictive value in identifying the risk of cardiovascular disease (CVD) for patients with lupus considered to be at ‘low risk’ of the disease. The results of their study were presented at the Annual European Congress of Rheumatology (EULAR; Madrid, Spain; 14–17 July).

In the study, published in Arthritis Research and Therapy, the team measured the levels of High Sensitivity Cardiac Troponin T (HS-cTnT) in 63 lupus patients and 18 healthy individuals using a high sensitive assay (HS-cTnT Elecyss 2010 immunoassay). Both groups had low Framingham risk scores and therefore were not considered at risk for CVD. These results were then compared to the presence of carotid plaques, which was assessed prospectively by vascular ultrasound.

Through using vascular ultrasound, it was identified that 36.5% of the lupus patients and 11% of the control group had carotid plaques present. Out of the lupus patients who had detectable carotid plaques, 87% of them had high levels of HS-cTnT. After a multivariate analysis of the all the results it was identified that HS-cTnT levels were statistically associated with carotid plaques.

The overall findings suggested the risk of having fatty deposits in the carotid arteries that would contribute to atherosclerosis, was eight to nine times more likely to occur in lupus patients who had high levels of HS-cTnT in their blood. This is a significant finding since CVD has been recognized as one of the major causes of death and ill-health in patients with lupus. In fact, premenopausal women with lupus are more likely to experience premature CVD in comparison to women without lupus. Additionally, the risk of CVD is routinely underestimated using the Framingham score.

“The results of our study raise the possibility that this easily measured biomarker could be introduced into clinical practice as a more reliable way of evaluating CVD risk in lupus patients. This in turn will enable more effective primary prevention measures such as treating abnormally raised blood lipids to be implemented,” commented  lead author Karim Sacre (Paris Diderot University).

It is hoped that levels of HS-cTnT could be an adequate indication for predicting the risk of accelerated atherosclerosis in patients with lupus, but as Sacre explained, there were limitations in this study and further research is required before it is used in clinical practice: “Before introducing this new biomarker into clinical practice, we are conducting further research to confirm our findings on a larger cohort of patients, with a longer follow up period, analyzing not only carotid plaques, but also the occurrence of major cardiovascular events.”

Sources: Divard G, Abbas R, Chenevier-Gobeaux C et al. High-sensitivity cardiac troponin T is a biomarker for atherosclerosis in systemic lupus erythematous patients: a cross-sectional controlled study. Arthritis Res. Ther. 19:132 (2017);
www.eular.org/congresspressreleases/New_blood_test_detects_stroke_and_heart_attack_risk_in_lupus_patients_wi.pdf

 

 

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