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ABSTRACT BACKGROUND A 24-year-old woman with an 11-year history of systemic lupus erythematosus presented with exacerbation of chronic abdominal pain followed by substernal chest pain. She

had a history of pericarditis secondary to systemic lupus erythematosus and of varicella-zoster reactivation secondary to immunosuppression. Long-term medications included prednisolone,

hydroxychloroquine, aspirin, and mycophenolate mofetil. INVESTIGATIONS Physical examination, mesenteric angiography, CT of the abdomen, esophagogastroduodenoscopy, colonoscopy, pelvic

ultrasound, laboratory testing, serologic testing, cardiac echocardiography, electrocardiography and coronary angiography. DIAGNOSIS Acute myocardial infarction secondary to severe

multivessel atherosclerotic coronary artery disease. MANAGEMENT Intra-aortic balloon pump followed by emergent four-vessel coronary artery bypass grafting. Aspirin, hydroxychloroquine, and

mycophenolate mofetil were continued and a judicious tapering of prednisolone was initiated. Access through your institution Buy or subscribe This is a preview of subscription content,

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OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Nikpour M et al. (2005) Premature atherosclerosis in systemic lupus

erythematosus. _Rheum Dis Clin North Am_ 31: 329–354 Article  Google Scholar  * Toloza SMA et al. (2004) Systemic lupus erythematosus in a multiethnic US cohort (LUMINA) XXIII. Baseline

predictors of vascular events. _Arthritis Rheum_ 50: 3947–3957 Article  Google Scholar  * Fessler BJ et al. (2005) Systemic lupus erythematosus in three ethnic groups XVI. Association of

hydroxychloroquine use with reduced risk of damage accrual. _Arthritis Rheum_ 52: 1473–1480 Article  Google Scholar  * Manzi S et al. (1997) Age-specific incidence rates of myocardial

infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham Study. _Am J Epidemiol_ 145: 408–415 Article  CAS  Google Scholar  * Sella EM et al. (2003)

Myocardial perfusion scintigraphy and coronary disease risk factors in systemic lupus erythematosus. _Ann Rheum Dis_ 62: 1066–1070 Article  CAS  Google Scholar  * Kwok Y et al. (1999)

Meta-analysis of exercise testing to detect coronary artery disease in women. _Am J Cardiol_ 83: 660–666 Article  CAS  Google Scholar  * Jimenez S et al. (2005) Preclinical vascular disease

in systemic lupus erythematosus and primary antiphospholipid syndrome. _Rheumatology_ 44: 756–761 Article  Google Scholar  * Asanuma Y et al. (2003) Premature coronary-artery atherosclerosis

in systemic lupus erythematosus. _N Engl J Med_ 349: 2407–2415 Article  CAS  Google Scholar  * Birdas TJ et al. (2005) Outcomes of coronary artery bypass grafting in patients with

connective tissue diseases. _Ann Thorac Surg_ 79: 1610–1614 Article  Google Scholar  * Wajed J et al. (2004) Prevention of cardiovascular disease in systemic lupus erythematosus—proposed

guidelines for risk factor management. _Rheumatology_ 43: 7–12 Article  CAS  Google Scholar  * Wahl DG et al. (2000) Prophylactic antithrombotic therapy for patients with systemic lupus

erythematosus with or without antiphospholipid antibodies: do the benefits outweigh the risks? A decision analysis. _Arch Int Med_ 160: 2042–2048 Article  CAS  Google Scholar  * Ridker PM et

al. (2005) A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. _N Engl J Med_ 352: 1293–1304 Article  CAS  Google Scholar  * Antithrombotic

Trialists' Collaboration (2002) Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk

patients. _BMJ_ 324: 71–86 * Kang S et al. (2004) Effects of statin therapy on the progression of carotid atherosclerosis: a systematic review and meta-analysis. _Atherosclerosis_ 177:

433–442 Article  CAS  Google Scholar  * Jury EC and Ehrenstein MR (2005) Statins: immunomodulators for autoimmune rheumatic disease? _Lupus_ 14: 192–196 Article  CAS  Google Scholar  * Kiana

A and Petri M (2004) Predictors of statin toxicity in the Lupus Atherosclerosis Prevention Study [abstract]. _Arthritis Rheum_ 50 (Suppl): S406 Google Scholar  * Petri M et al. (1994)

Effect of prednisone and hydroxychloroquine on coronary artery disease risk factors in systemic lupus erythematosus: a longitudinal data analysis. _Am J Med_ 96: 254–259 Article  CAS  Google

Scholar  Download references ACKNOWLEDGEMENTS Written consent for publication was obtained from the patient reported in this Case Study. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS *

Clinical Instructor of Medicine at the David Geffen School of Medicine at University California, Los Angeles, USA Michael Galindo * Fellow in the Division of Immunology and Rheumatology,

Lorinda Chung, Seth D Crockett & Eliza F Chakravarty * Resident Physician in Internal Medicine and EF Chakravarty is an Assistant Professor in the Division of Immunology and Rheumatology

at Stanford University, Stanford, USA Lorinda Chung, Seth D Crockett & Eliza F Chakravarty Authors * Michael Galindo View author publications You can also search for this author

inPubMed Google Scholar * Lorinda Chung View author publications You can also search for this author inPubMed Google Scholar * Seth D Crockett View author publications You can also search

for this author inPubMed Google Scholar * Eliza F Chakravarty View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to

Eliza F Chakravarty. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing financial interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE

THIS ARTICLE Galindo, M., Chung, L., Crockett, S. _et al._ Coronary artery disease in patients with systemic lupus erythematosus. _Nat Rev Rheumatol_ 1, 55–59 (2005).

https://doi.org/10.1038/ncprheum0037 Download citation * Received: 22 June 2005 * Accepted: 02 September 2005 * Issue Date: November 2005 * DOI: https://doi.org/10.1038/ncprheum0037 SHARE

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