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

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dc.Chemicals/CASazathioprine, 446-86-6; cyclophosphamide, 50-18-0; cyclosporin A, 59865-13-3, 63798-73-2; hydroxychloroquine, 118-42-3, 525-31-5; immunoglobulin, 9007-83-4; methylprednisolone, 6923-42-8, 83-43-2; mycophenolic acid, 23047-11-2, 24280-93-1; prednisolone, 50-24-8; tacrolimus, 104987-11-3; Adrenal Cortex Hormones; Cyclosporine, 59865-13-3; Immunosuppressive Agents
dc.FundingDetailsUniversiti Kebangsaan Malaysia: FF027 2009
dc.FundingDetailsThis work was supported by UKM Research Grant: FF027 2009.
dc.citedby22
dc.contributor.affiliationsFaculty of Medicine and Health Sciences
dc.contributor.affiliationsUniversiti Kebangsaan Malaysia (UKM) Medical Centre
dc.contributor.affiliationsUniversiti Putra Malaysia (UPM)
dc.contributor.affiliationsUniversiti Sains Islam Malaysia (USIM)
dc.contributor.authorSazliyana S.en_US
dc.contributor.authorMohd Shahrir M.S.en_US
dc.contributor.authorKong C.N.en_US
dc.contributor.authorTan H.J.en_US
dc.contributor.authorHamidon B.B.en_US
dc.contributor.authorAzmi M.T.en_US
dc.date.accessioned2024-05-28T08:40:13Z
dc.date.available2024-05-28T08:40:13Z
dc.date.issued2011
dc.description.abstractIntroduction: 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 (rs = -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.en_US
dc.description.natureFinalen_US
dc.identifier.CODENLUPUE
dc.identifier.doi10.1177/0961203311411347
dc.identifier.epage1266
dc.identifier.issn9612033
dc.identifier.issue12
dc.identifier.pmid21844115
dc.identifier.scopus2-s2.0-80053631005
dc.identifier.spage1260
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-80053631005&doi=10.1177%2f0961203311411347&partnerID=40&md5=e244a48332a8e9ccfc79f61589fc86fe
dc.identifier.urihttps://oarep.usim.edu.my/handle/123456789/9261
dc.identifier.volume20
dc.languageEnglish
dc.language.isoen_USen_US
dc.relation.ispartofLupus
dc.sourceScopus
dc.subjectcarotid media intimal thickness (CIMT)en_US
dc.subjectcyclosporine Aen_US
dc.subjectlupus nephritisen_US
dc.subjecttraditional cardiovascular risk factorsen_US
dc.titleImplications of immunosuppressive agents in cardiovascular risks and carotid intima media thickness among lupus nephritis patientsen_US
dc.title.alternativeLupusen_US
dc.typeArticleen_US
dspace.entity.typePublication

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