To compare epicardial fat thickness with carotid intimal media thickness in predicting cardiovascular risk in patients with systemic lupus erythematosus

Abstract Introduction Systemic Lupus erythematous (SLE) is an autoimmune disease. In the past two decades, mortality of patients with SLE has declined, 5 years survival has increased to nearly 90 %. Despite this, morbidity 1/3rd of all deaths).(1) Literature states that patient with SLE have 50-fold increase risk of developing CV disease as compare to controls. This atherosclerosis risk increases with each year of disease duration. CIMT is considered to be surrogate marker for atherosclerotic CAD. High atherogenic CV risk can be assessed by TMT, ABPI, dobutamine stress echocardiogram, CT angiography or the gold standard test i.e., coronary angiography and lastly CIMT. CIMT measurement is a cumbersome, expensive and long procedure which needs experienced radiologists and expensive tools like Doppler USG. Also, presence of plaques in the vessels make the measurement of CIMT erroneous. Epicardial fat is associated with high metabolic activity, increased release of adipokines, inflammatory cytokines and chemokines. EFT is an emerging marker of cardiometabolic risk measured by 2D Echo .0001). Mean CIMT in cases was significantly higher as compared to control (0.62 ± 0.14mm vs 0.5 ± 0.09mm (.0001). According to literature, CIMT ≥ 0.6 mm is considered abnormal (2). So, cases and controls was divided accordingly and result was obtained, as shown in table 1. Based on CIMT 56.67% cases were found to be at increased CV risk as compared to 10% amongst controls. (p.0001).The mean EFT in cases with high CIMT i.e. 0.6 mm was 5.56 ± 0.69 mm which was significantly higher as compared to 4.01 ± 0.92 mm in cases with low CIMT i.e. =0.6 mm (p.0001) as shown in table 2. Receiver operating characteristic curve of EFT for predicting CV risk based on CIMT revealed that at value of EFT = 5 - 5.2 mm, the sensitivity and specificity of picking subclinical CAD was 85.29% and 92.3% respectively. Good agreement was seen to exist between cardiovascular risk based on CIMT and Epicardial fat thickness with kappa value 0.766 (p .0001). Conclusion EFT is increasingly being recognized as a precursor of cardiovascular disease. At EFT (mm) 5-5.2, sensitivity was 85.3 % and specificity was 92.3% for predicting cardiovascular risk in patient with SLE.Comparison of CV risk based on CIMT Association of EFT with CIMT in cases