{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T03:23:28Z","timestamp":1782962608561,"version":"3.54.5"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,12,30]],"date-time":"2013-12-30T00:00:00Z","timestamp":1388361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>An increased frequency of atherosclerosis (ATH) in systemic lupus erythematosus (SLE) is well\u2010documented but not fully explained by the presence of traditional cardiac risk factors. Several nontraditional biomarkers, including proinflammatory high\u2010density lipoprotein (piHDL) and leptin, have been individually associated with subclinical ATH in SLE. The aim of this study was to examine whether these and other biomarkers can be combined into a risk profile, the Predictors of Risk for Elevated Flares, Damage Progression, and Increased Cardiovascular Disease in Patients with SLE (PREDICTS), that could be used to better predict future progression of ATH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 210 patients with SLE and 100 age\u2010matched healthy control subjects (all women) participated in this prospective cohort study. The longitudinal presence of carotid plaque and intima\u2010media thickness (IMT) were measured at baseline and followup (mean \u00b1 SD 29.6 \u00b1 9.7 months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At followup, carotid plaque was present in 29% of SLE patients. Factors significantly associated with plaque, determined using Salford Predictive Modeling and multivariate analysis, included age \u226548 years (odds ratio [OR] 4.1, <jats:italic>P<\/jats:italic> = 0.002), high piHDL function (OR 9.1, <jats:italic>P<\/jats:italic> &lt; 0.001), leptin levels \u226534 ng\/dl (OR 7.3, <jats:italic>P<\/jats:italic> = 0.001), plasma soluble TWEAK levels \u2265373 pg\/ml (OR 28.8, <jats:italic>P<\/jats:italic> = 0.004), and history of diabetes (OR 61.8, <jats:italic>P<\/jats:italic> &lt; 0.001). Homocysteine levels \u226512 \u03bcmoles\/liter were also a predictor. However, no single variable demonstrated an ideal combination of good negative predictive values (NPVs), positive predictive values (PPVs), sensitivity, and specificity. A high\u2010risk PREDICTS profile was defined as \u22653 positive biomarkers or \u22651 positive biomarker plus a history of diabetes; for high\u2010risk SLE patients, the PPV was 64%, NPV was 94%, sensitivity was 89%, and specificity was 79%. In multivariate analysis, SLE patients with the high\u2010risk profile had 28\u2010fold increased odds for the longitudinal presence of plaque (<jats:italic>P<\/jats:italic> &lt; 0.001) and increased progression of IMT (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A high\u2010risk PREDICTS score confers 28\u2010fold increased odds of the presence of any current, progressive, or acquired carotid plaque, both in patients with SLE and in control subjects, and is significantly associated with higher rates of IMT progression.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.38204","type":"journal-article","created":{"date-parts":[[2013,10,11]],"date-time":"2013-10-11T18:22:42Z","timestamp":1381515762000},"page":"130-139","source":"Crossref","is-referenced-by-count":107,"title":["A Panel of Biomarkers Is Associated With Increased Risk of the Presence and Progression of Atherosclerosis in Women With Systemic Lupus 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