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Научно-практическая ревматология

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Сердечно-сосудистые осложнения при системной красной волчанке: механизмы ускоренного развития атеросклероза, диагностика, возможности коррекции

https://doi.org/10.14412/1995-4484-2017-304-310

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Аннотация

Атеросклероз и его осложнения – главная причина поздней смертности среди пациентов с системной красной волчанкой (СКВ). СКВ и ишемическую болезнь сердца (ИБС) объединяют общие патофизиологические механизмы, связанные с системным и хроническим воспалением. В то же время традиционные факторы риска, например артериальная гипертензия, пожилой возраст, курение, гиперхолестеринемия, ожирение и мужской пол, не могут полностью объяснить механизм ускоренного развития атеросклероза у пациентов с СКВ. Наличие специфических факторов риска, таких как длительность течения, применение глюкокортикоидов, присутствие аутоантител к двуспиральной (нативной) ДНК и наличие антифосфолипидных антител, создают условия для ускорения развития атеросклероза в данной группе больных.

Имеющиеся факты указывают на то, что ревматолог может понизить риск развития сердечно-сосудистых заболеваний (ССЗ), контролируя активность СКВ. Также должна проводиться коррекция традиционных факторов риска ССЗ, начиная с отказа от курения, контроля массы тела и артериального давления. Необходимо учитывать роль проводимой противовоспалительной терапии, в частности позитивное влияние таких препаратов, как противомалярийные средства и микофенолата мофетил, и прогностически неблагоприятный эффект длительного применения глюкокортикоидов. Дальнейшие исследования должны помочь разработать эффективные шкалы риска развития, конкретные терапевтические программы профилактики и лечения ССЗ у больных СКВ. 

Об авторах

А. В. Аршинов
ГБОУ ВПО «Ярославский государственный медицинский университет» Минздрава России, Ярославль
Россия

150000 Ярославль, ул. Революционная, 5 



Н. Ю. Левшин
ГБОУ ВПО «Ярославский государственный медицинский университет» Минздрава России, Ярославль
Россия

150000 Ярославль, ул. Революционная, 5 



И. Г. Маслова
ГБОУ ВПО «Ярославский государственный медицинский университет» Минздрава России, Ярославль
Россия

150000 Ярославль, ул. Революционная, 5 



Список литературы

1. Насонов ЕЛ. Антифосфолипидный синдром. Москва: Литтерра; 2004. 440 с. [Nasonov EL. Antifosfolipidnyi sindrom [Antiphospholipid syndrome]. Moscow: Litterra; 2004. 440 p.].

2. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis. 2008;67:195-205. doi: 10.1136/ard.2007.070367

3. Liu Z, Davidson A. Taming lupus – a new understanding of pathogenesis is leading to clinical advances. Nature Medicine. 2012;18(6):871-82. doi: 10.1038/nm.2752

4. D'Cruz DP, Khamashta MA, Hughes GR. Systemic lupus erythematosus. Lancet. 2007;369(9561):587-96. doi: 10.1016/S0140- 6736(07)60279-7

5. Rubin LA, Urowitz MB, Gladman DD. Mortality in systemic lupus erythematosus: the bimodal pattern revisited. Q J Med. 1985;55(216):87-98.

6. Urowitz MB, Bookman AA, Koehler BE, et al. The bimodal mortality pattern of systemic lupus erythematosus. Am J Med. 1976;60(2):221-5. doi: 10.1016/0002-9343(76)90431-9

7. Bjö rnadal L, Yin L, Granath F, et al. Cardiovascular disease a hazard despite improved prognosis in patients with systemic lupus erythematosus: results from a Swedish population based study 1964- 95. J Rheumatol. 2004;31(4):713-9.

8. Nossent J, Cikes N, Kiss E, et al. Current causes of death in systemic lupus erythematosus in Europe, 2000-2004: relation to disease activity and damage accrual. Lupus. 2007;16(5):309-17. doi: 10.1177/0961203307077987

9. Amaya-Amaya J, Sarmiento-Monroy JC, Caro-Moreno J, et al. Cardiovascular disease in latin american patients with systemic lupus erythematosus: a cross-sectional study and a systematic review. Autoimmune Dis. 2013;2013:Article ID 794383, 20 p. doi: 10.1155/2013/794383

10. McMahon M, Skaggs B. Pathogenesis and treatment of atherosclerosis in lupus. Rheum Dis Clin North Am. 2014;40(3):475-95.

11. Van Leuven SI, van Wijk DF, Volger OL, et al. Mycophenolate mofetil attenuates plaque inflammation in patients with symptomatic carotid artery stenosis. Atherosclerosis. 2010;211(1):231-6. doi: 10.1016/j.atherosclerosis.2010.01.043

12. Petri M. The lupus anticoagulant is a risk factor for myocardial infarction (but not atherosclerosis): Hopkins Lupus Cohort. Thromb Res. 2004;114(5-6):593-5. doi: 10.1016/j.thromres.2004.07.012

13. Magder LS, Petri M. Incidence of and risk factors for adverse cardiovascular events among patients with systemic lupus erythematosus. Am J Epidemiol. 2012;176(8):708-19. doi: 10.1093/aje/kws130

14. Esdaile JM, Abrahamowicz M, Grodzicky T, et al. Traditional Framingham risk factors fail to fully account for accelerated atherosclerosis in systemic lupus erythematosus. Arthritis Rheum. 2001;44(10):2331-7. doi: 10.1002/1529- 0131(200110)44:103.0.CO;2-I

15. Trager J, Ward MM. Mortality and causes of death in systemic lupus erythematosus. Curr Opin Rheumatol. 2001;13:345-51. doi: 10.1097/00002281-200109000-00002

16. Bruce IN. 'Not only... but also': factors that contribute to accelerated atherosclerosis and premature coronary heart disease in systemic lupus erythematosus. Rheumatology (Oxford). 2005;44(12):1492-502. doi: 10.1093/rheumatology/kei142

17. Manzi S, Meilahn EN, Rairie JE, et al. Age-specific incidence rates ofmyocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham study. Amer J Epidemiol. 1997;145(5):408-15. doi: 10.1093/oxfordjournals.aje.a009122

18. Kiani AN, Magder LS, Petri M. Mycophenolate mofetil (MMF) does not slow the progression of subclinical atherosclerosis in SLE over 2 years. Rheumatol Int. 2012;32(9):2701-5. doi: 10.1007/s00296-011-2048-y

19. Doria A, Iaccarino L, Ghirardello A, et al. Long-term prognosis and causes of death in systemic lupus erythematosus. Amer J Med. 2006;119(8):700-6. doi: 10.1016/j.amjmed.2005.11.034

20. Ильина АЕ, Клюквина НГ, Александрова ЕН и др. Атеросклеротическое поражение сосудов при системной красной волчанке и антифосфолипидном синдроме у мужчин. Клиническая медицина. 2006;(4):23-8 [Il'ina AE, Klyukvina NG, Aleksandrova EN, et al. Atherosclerotic vascular lesions in systemic lupus erythematosus and antiphospholipid syndrome in men. Klinicheskaya Meditsina. 2006;(4):23-8 (In Russ.)].

21. McMahon M, Grossman J, Chen W, et al. Inflammation and the pathogenesis of atherosclerosis in systemic lupus erythematosus. Lupus. 2006;15:59-69. doi: 10.1177/0961203306071668

22. Sinicato NA, da Silva Cardoso PA, Appenzeller S. Risk factors in cardiovascular disease in systemic lupus erythematosus. Curr Cardiol Rev. 2013;19(1):15-9.

23. Narshi CB, Giles IP, Rahman A. The endothelium: an interface between autoimmunity and atherosclerosis in systemic lupus erythematosus? Lupus. 2011;20(1):5-13. doi: 10.1177/0961203310382429

24. Ames PR, Margarita A, Sokoll KB, et al. Premature atherosclerosis in primary antiphospholipid syndrome: preliminary data. Ann Rheum Dis. 2005;64(2):315-7. doi: 10.1136/ard.2004.023952

25. Ames PR, Margarita A, Alves JD. Antiphospholipid antibodies and atherosclerosis: insights from systemic lupus erythematosus and primary antiphospholipid syndrome. Clin Rev Allergy Immunol. 2009;37(1):29-35. doi: 10.1007/s12016-008-8099-5

26. Gresele P, Migliacci R, Vedovati MC, et al. Patients with primary antiphospholipid antibody syndrome and without associated vascular risk factors present a normal endothelial function. Thromb Res. 2009;123(3):444-51. doi: 10.1016/j.thromres.2008.05.015

27. Petri M. Update on anti-phospholipid antibodies in SLE: the Hopkins' Lupus Cohort. Lupus. 2010;19(4):419-23. doi: 10.1177/0961203309360541

28. O'Neill SG, Giles I, Lambrianides A, et al. Antibodies to apolipoprotein A-I, high-density lipoprotein, and C-reactive protein are associated with disease activity in patients with systemic lupus erythematosus. Arthritis Rheum. 2010;62(3):845-54. doi: 10.1002/art.27286

29. Mandal K, Foteinos G, Jahangiri M, et al. Role of antiheat shock protein 60 autoantibodies in atherosclerosis. Lupus. 2005;14(9):742-6. doi: 10.1191/0961203305lu2212oa

30. Fangtham M, Petri M. 2013 update: Hopkins lupus cohort. Curr Rheumatol Rep. 2013;15(9):360. doi: 10.1007/s11926-013-0360-0

31. Motoki Y, Nojima J, Yanagihara M, et al. Anti-phospholipid antibodies contribute to arteriosclerosis in patients with systemic lupus erythematosus through induction of tissue factor expression and cytokine production from peripheral blood mononuclear cells. Thromb Res. 2012;130(4):667-73. doi: 10.1016/j.thromres.2011.11.048

32. Loeffen R, Spronk HM, ten Cate H. The impact of blood coagulability on atherosclerosis and cardiovascular disease. J Thromb Haemost. 2012;10(7):1207-16. doi: 10.1111/j.1538- 7836.2012.04782.x

33. Boles J, Mackman N. Role of tissue factor in thrombosis in antiphospholipid antibody syndrome. Lupus. 2010;19(4):370-8. doi: 10.1177/0961203309360810

34. Mayadas TN, Tsokos GC, Tsuboi N. Mechanisms of immune complex-mediated neutrophil recruitment and tissue injury. Circulation. 2009;120:2012-24. doi: 10.1161/CIRCULATIONAHA.108.771170

35. Tsokos GC. Mechanisms of disease systemic lupus erythematosus. N Engl J Med. 2011;365:2110-21. doi: 10.1056/NEJMra1100359

36. Rajagopalan S, Somers EC, Brook RD, et al. Endothelial cell apoptosis in systemic lupus erythematosus: a common pathway for abnormal vascular function and thrombosis propensity. Blood. 2004;103:3677-83. doi: 10.1182/blood-2003-09-3198

37. Ruiz-Limon P, Barbarroja N, Perez-Sanchez C, et al. Atherosclerosis and cardiovascular disease in systemic lupus erythematosus: effects of in vivo statin treatment. Ann Rheum Dis. 2015;74(7):1450-8. doi: 10.1136/annrheumdis-2013-204351

38. Thacker SG, Duquaine D, Park J, et al. Lupus-prone New Zealand Black/New Zealand White F1 mice display endothelial dysfunction and abnormal phenotype and function of endothelial progenitor cells. Lupus. 2010;19(3):288-99. doi: 10.1177/0961203309353773

39. Thacker SG, Zhao W, Smith CK, et al. Type I interferons modulate vascular function, repair, thrombosis, and plaque progression in murine models of lupus and atherosclerosis. Arthritis Rheum. 2012;64(9):2975-85. doi: 10.1002/art.34504

40. Trinchieri G. Type I interferon: friend or foe? J Exp Med. 2010;207(10):2053-63. doi: 10.1084/jem.20101664

41. Knight JS, Kaplan MJ. Cardiovascular disease in lupus: insights and updates. Curr Opin Rheumatol. 2013;25(5):597-605. doi: 10.1097/BOR.0b013e328363eba3

42. Brinkmann V, Reichard U, Goosmann C, et al. Neutrophil extracellular traps kill bacteria. Science. 2004;303(5663):1532-5. doi: 10.1126/science.1092385

43. Brinkmann V, Zychlinsky A. Neutrophil extracellular traps: is immunity the second function of chromatin? J Cell Biol. 2012;198(5):773-83. doi: 10.1083/jcb.201203170

44. Hakkim A, Furnrohr BG, Amann K, et al. Impairment of neutrophil extracellular trap degradation is associated with lupus nephritis. Proc Natl Acad Sci USA. 2010;107(21):9813-8. doi: 10.1073/pnas.0909927107

45. Leffler J, Martin M, Gullstrand B, et al. Neutrophil extracellular traps that are not degraded in systemic lupus erythematosus activate complement exacerbating the disease. J Immunol. 2012;188(7):3522-31. doi: 10.4049/jimmunol.1102404

46. Garcia-Romo GS, Caielli S, Vega B, et al. Netting neutrophils are major inducers of type I IFN production in pediatric systemic lupus erythematosus. Sci Transl Med. 2011;3(73):73ra20. doi: 10.1126/scitranslmed.3001201

47. Lande R, Ganguly D, Facchinetti V, et al. Neutrophils activate plasmacytoid dendritic cells by releasing self-DNA-peptide complexes in systemic lupus erythematosus. Sci Transl Med. 2011;3(73):73ra19.

48. Villanueva E, Yalavarthi S, Berthier CC, et al. Netting neutrophils induce endothelial damage, infiltrate tissues, and expose immunostimulatory molecules in systemic lupus erythematosus. J Immunol. 2011;187(1):538-52. doi: 10.4049/jimmunol.1100450

49. Davi G, Patrono C. Platelet activation and atherothrombosis. N Engl J Med. 2007;357(24):2482-94. doi: 10.1056/NEJMra071014

50. Vieira-de-Abreu A, Campbell RA, Weyrich AS, et al. Platelets: versatile effector cells in hemostasis, inflammation, and the immune continuum. Semin Immunopathol. 2012;34(1):5-30. doi: 10.1007/s00281-011-0286-4

51. Tam LS, Fan B, Li EK, et al. Patients with systemic lupus erythematosus show increased platelet activation and endothelial dysfunction induced by acute hyperhomocysteinemia. J Rheumatol. 2003;30(7):1479-84.

52. Duffau P, Seneschal J, Nicco C, et al. Platelet CD154 potentiates interferon-alpha secretion by plasmacytoid dendritic cells in systemic lupus erythematosus. Sci Transl Med. 2010;2(47):47ra63. doi: 10.1126/scitranslmed.3001001

53. Kaiser R, Li Y, Chang M, et al. Genetic risk factors for thrombosis in systemic lupus erythematosus. J Rheumatol. 2012;39(8):1603- 10. doi: 10.3899/jrheum.111451

54. Chang YH, Lin IL, Tsay GJ, et al. Elevated circulatory MMP-2 and MMP-9 levels and activities in patients with rheumatoid arthritis and systemic lupus erythematosus. Clin Biochem. 2008;41(12):955-9. doi: 10.1016/j.clinbiochem.2008.04.012

55. Bahrehmand F, Vaisi-Raygani A, Kiani A, et al. Matrix metalloproteinase-2 functional promoter polymorphism G1575A is associated with elevated circulatory MMP-2 levels and increased risk of cardiovascular disease in systemic lupus erythematosus patients. Lupus. 2012;21(6):616-24. doi: 10.1177/0961203312436857

56. McMahon M, Grossman J, Skaggs B, et al. Dysfunctional proinflammatory high-density lipoproteins confer increased risk of atherosclerosis in women with systemic lupus erythematosus. Arthritis Rheum. 2009;60(8):2428-37. doi: 10.1002/art.24677

57. Zampieri S, Iaccarino L, Ghirardello A, et al. Systemic lupus erythematosus, atherosclerosis, and autoantibodies. Ann N Y Acad Sci. 2005;1051:351-61. doi: 10.1196/annals.1361.077

58. Kawai VK, Solus JF, Oeser A, et al. Novel cardiovascular risk prediction models in patients with systemic lupus erythematosus. Lupus. 2011;20(14):1526-34. doi: 10.1177/0961203311420317

59. Symmons DPM, Gabriel SE. Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE. Nat Rev Rheumatol. 2011;7(7):399-408. doi: 10.1038/nrrheum.2011.75

60. Urowitz MB, Gladman D, Ibanez D, et al. Atherosclerotic vascular events in a multinational inception cohort of systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2010;62:881-7. doi: 10.1002/acr.20122

61. Schoenfeld SR, Kasturi S, Costenbader KH. The epidemiology of atherosclerotic cardiovascular disease among patients with SLE: a systematic review. Semin Arthr Rheum. 2013;43(1):77-95. doi: 10.1016/j.semarthrit.2012.12.002

62. Genest J, McPherson R, Frohlich J, et al. 2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult – 2009 recommendations. Can J Cardiol. 2009;25(10):567-79. doi: 10.1016/S0828-282X(09)70715-9

63. Ridker PM, MacFadyen J, Cressman M, et al. Efficacy of rosuvastatin among men and women with moderate chronic kidney disease and elevated high-sensitivity C-reactive protein: a secondary analysis from the JUPITER (Justification for the Use of Statins in Prevention-an Intervention Trial Evaluating Rosuvastatin) trial. J Am Coll Cardiol. 2010;55(12):1266-73. doi: 10.1016/j.jacc.2010.01.020

64. Pons-Estel GJ, Gonzalez LA, Zhang J, et al. Predictors of cardiovascular damage in patients with systemic lupus erythematosus: data from LUMINA (LXVIII), a multiethnic US cohort. Rheumatology (Oxford). 2009;487:817-22. doi: 10.1093/rheumatology/kep102

65. Gustafsson J, Simard JF, Gunnarsson I, et al. Risk factors for cardiovascular mortality in patients with systemic lupus erythematosus, a prospective cohort study. Arthritis Res Ther. 2012;14(2):46. doi: 10.1186/ar3759

66. Nikpour M, Harvey PJ, Ibanez D, et al. High-sensitivity C-reactive protein as a marker of cardiovascular risk in systemic lupus erythematosus. Arthritis Rheum. 2012;64(9):3052-3. doi: 10.1002/art.34541

67. Wu GC, Liu HR, Leng RX, et al. Subclinical atherosclerosis in patients with systemic lupus erythematosus: A systemic review and meta-analysis. Autoimmun Rev. 2016;15(1):22-37. doi: 10.1016/j.autrev.2015.10.002

68. Tselios K, Sheane BJ, Gladman DD, Urowitz MB. Optimal monitoring for coronary heart disease risk in patients with systemic lupus erythematosus: A systematic review. J Rheumatol. 2016;43(1):54-65. doi: 10.3899/jrheum.150460

69. Petri M, Magder L. SLE cardiovascular risk equation. Lupus. 2013;22(1):3-5.

70. Jastrzebska M, Czok ME, Guzik P. Autoimmune diseases, their pharmacological treatment and the cardiovascular system. Cardiol J. 2013;20(6):569-76. doi: 10.5603/CJ.2013.0156

71. Fardet L. Corticosteroid-induced clinical adverse events: Frequency, risk factors and patient's opinion. Br J Dermatol. 2007;157:142-8. doi: 10.1111/j.1365-2133.2007.07950.x

72. Nakajima A, Doki K, Homma M, et al. Investigation of glucocorticoidinduced side effects in patients with autoimmune diseases. Yakugaku Zasshi. 2009;129:445-50. doi: 10.1248/yakushi.129.445

73. Linos E, Fiorentino D, Lingala B. Atherosclerotic cardiovascular disease and ermatomyositis: an analysis of the Nationwide Inpatient Sample survey. Arthritis Res Ther. 2013;15:1-5. doi: 10.1186/ar4135

74. Tisseverasinghe A, Bernatsky S, Pineau C. Arterial events in persons with dermatomyositis and polymyositis. J Rheumatol. 2009;36:1-4. doi: 10.3899/jrheum.090061

75. Selzer F, Sutton-Tyrrell K, Fitzgerald S, et al. Vascular stiffness in women with systemic lupus erythematosus. Hypertension. 2001;37(4):1075-82. doi: 10.1161/01.HYP.37.4.1075

76. Roman MJ, Shanker BA, Davis A, et al. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med. 2003;349(25):2399-406. doi: 10.1056/NEJMoa035471

77. Rahman P, Gladman DD, Urowitz MB, et al. The cholesterol lowering effect of antimalarial drugs is enhanced in patients with lupus taking corticosteroid drugs. J Rheumatol. 1999;26(2):325-30.

78. Jung H, Bobba R, Su J, et al. The protective effect of antimalarial drugs on thrombovascular events in systemic lupus erythematosus. Arthritis Rheum. 2010;62(3):863-8. doi: 10.1002/art.27289

79. Law G, Magder LS, Fang H, et al. Hydroxychloroquine Reduces Thrombosis (BOTH ARTERIAL AND VENOUS) in Systemic LUPUS Erythematosus, Particularly in Antiphospholipid Positive Patients. American College of Rheumatology 76th Annual Meeting; November 9-14, 2012. Washington, D.C.; 2012.

80. Linos E, Fiorentino D, Lingala B. Atherosclerotic cardiovascular disease and ermatomyositis: an analysis of the Nationwide Inpatient Sample survey. Arthritis Res Ther. 2013;15:1-5. doi: 10.1186/ar4135

81. Costedoat-Chalumeau N, Hulot JS. Heart conduction disorders related to antimalarials toxicity: an analysis of electrocardiograms in 85 patients treated with hydroxychloroquine for connective tissue diseases. Rheumatology. 2007;46:808-10. doi: 10.1093/rheumatology/kel402

82. Iudici M, Fasano S, Gabriele Falcone L, et al. Low-dose aspirin as primary prophylaxis for cardiovascular events in systemic lupus erythematosus: a long-term retrospective cohort study. Rheumatology (Oxford). 2016;55(9):1623-30. doi: 10.1093/rheumatology/kew231

83. Van Leuven SI, Mendez-Fernandez YV, Wilhelm AJ, et al. Mycophenolate mofetil but not atorvastatin attenuates atherosclerosis in lupus-prone LDLr(–/–) mice. Ann Rheum Dis. 2012;71(3):408-14. doi: 10.1136/annrheumdis-2011-200071

84. Mason JC, Libby P. Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumatologic conditions. Eur Heart J. 2015;36(8):482-9. doi: 10.1093/eurheartj/ehu403

85. Aprahamian T, Bonegio RG, Richez C, et al. The peroxisome proliferator-activated receptor gamma agonist rosiglitazone ameliorates murine lupus by induction of adiponectin. J Immunol. 2009;182(1):340-6. doi: 10.4049/jimmunol.182.1.340

86. Zhao W, Thacker SG, Hodgin JB, et al. The peroxisome proliferator-activated receptor gamma agonist pioglitazone improves cardiometabolic risk and renal inflammation in murine lupus. J Immunol. 2009;183(4):2729-40. doi: 10.4049/jimmunol.0804341

87. Zuarez-Rojas JG, Medina-Urrutia AX, Jorge-Galarza E, et al. Pioglitazone improves the cardiovascular profile in patients with uncomplicated systemic lupus erythematosus: a double-blind randomized clinical trial. Lupus. 2012;21(1):27-35. doi: 10.1177/0961203311422096

88. Khattri S, Zandman-Goddard G. Statins and autoimmunity. Immunol Res. 2013;56(2-3):348-57. doi: 10.1007/s12026-013- 8409-8

89. Willis R, Seif AM, McGwin G Jr, et al. Effects of statins on proinflammatory/prothrombotic biomarkers and on disease activity scores in SLE patients: data from LUMINA (LXXVI), a multiethnic US cohort. Clin Exp Rheumatol. 2014;32(2):162-7.

90. Lawman S, Mauri C, Jury EC, et al. Atorvastatin inhibits autoreactive B cell activation and delays lupus development in New Zealand black/white F1 mice. J Immunol. 2004;173(12):7641-6. doi: 10.4049/jimmunol.173.12.7641

91. Aprahamian T, Bonegio R, Rizzo J, et al. Simvastatin treatment ameliorates autoimmune disease associated with accelerated atherosclerosis in a murine lupus model. J Immunol. 2006;177(5):3028- 34. doi: 10.4049/jimmunol.177.5.3028

92. Petri MA, Kiani AN, Post W, et al. Lupus Atherosclerosis Prevention Study (LAPS). Ann Rheum Dis. 2011;70:760-5. doi: 10.1136/ard.2010.136762

93. Schanberg LE, Sandborg C, Barnhart HX, et al. Use of atorvastatin in systemic lupus erythematosus in children and adolescents. Arthritis Rheum. 2012;64(1):285-96. doi: 10.1002/art.30645


Для цитирования:


Аршинов А.В., Левшин Н.Ю., Маслова И.Г. Сердечно-сосудистые осложнения при системной красной волчанке: механизмы ускоренного развития атеросклероза, диагностика, возможности коррекции. Научно-практическая ревматология. 2017;55(3):304-310. https://doi.org/10.14412/1995-4484-2017-304-310

For citation:


Arshinov A.V., Levshin N.Y., Maslova I.G. CARDIOVASCULAR EVENTS IN SYSTEMIC LUPUS ERYTHEMATOSUS: MECHANISMS FOR THE ACCELERATED DEVELOPMENT OF ATHEROSCLEROSIS, DIAGNOSIS, CORRECTION CAPABILITIES. Rheumatology Science and Practice. 2017;55(3):304-310. (In Russ.) https://doi.org/10.14412/1995-4484-2017-304-310

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ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)