Cardiovascular Issues in SLE

Cardiovascular disease is a significant cause of morbidity and mortality in systemic lupus erythematosus (SLE) patients. Both traditional cardiovascular risk factors and SLE-specific related risk factors contribute to an accelerated atherosclerosis. Their identification and control together with an aggressive treatment to reduce disease activity are the mainstays of cardiovascular disease prevention. The emerging evidence about the beneficial effects of some medications (both SLE and non-SLE related) could support their future use as preventive tools. Additionally, several cardiac manifestations can occur in SLE patients, with a variable reported prevalence. Pericarditis is the only cardiac abnormality included in the classification criteria of SLE, but myocardial and valvular involvements are also common. The pathogenesis of these complications usually includes immune complex deposition, leading to inflammation and eventually fibrosis, and medium to high doses of steroids are usually used to treat the acute phases. The prognosis of SLE patients with primary cardiac disease has considerably improved over time in parallel with the improvement of the diagnostic methodologies to assess heart involvement and the therapeutic strategies for SLE.