LUPUS ATHEROSCLEROSIS PREVENTION STUDY (LAPS)

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 心血管疾病，特别是动脉粥样硬化，是发达国家系统性红斑狼疮死亡的主要原因。冠状动脉疾病和中风会导致存活患者的长期发病率。系统性红斑狼疮的动脉粥样硬化是多因素的，免疫/炎性内皮损伤、传统的心血管危险因素和血栓前因子都起着重要作用。多组研究表明，高脂血症预示着SLE患者日后的动脉粥样硬化。在普通人群中，他汀类药物已成为预防动脉粥样硬化事件的首选药物，通过两种机制：帮助防止进展的降脂和稳定斑块以防止破裂。在狼疮动脉粥样硬化预防试验中，我们将通过螺旋CT和颈动脉双功评估阿托伐他汀是否能减少动脉粥样硬化的进展。最近的研究证实他汀类药物具有免疫调节作用。这项研究还将确定他汀类药物是否可以改善狼疮的临床活动性或狼疮血清学(抗dsDNA和补体)。这项临床试验将比较阿托伐他汀40毫克和安慰剂，其结果是颈动脉双功测量的新的或进展性动脉粥样硬化斑块。另一个结果将是颈动脉内膜中层厚度，这是动脉粥样硬化的替代变量。我们将利用螺旋CT评估他汀类药物治疗对冠状动脉钙化积分的影响。最终目的是确定哪些危险因素、传统的心血管危险因素、狼疮活动性、抗磷脂抗体和其他血栓前因子最能预测SLE的动脉粥样硬化。我们建议招收200名完成课程的学生，他们将被跟踪2年。已经向IRB提交了一项修正案，将受试者的数量增加到将招聘的人数提供200人完成。 心血管核心实验室被用于该方案。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Cardiovascular disease, specifically from atherosclerosis, is the major cause of mortality in SLE in developed countries. Coronary artery disease and stroke contribute to long-term morbidity in surviving patients. Atherosclerosis in SLE is multifactorial, with immune/inflammatory endothelial damage, traditional cardiovascular risk factors, and prothrombotic factors all playing important roles. Multiple groups have shown that hyperlipidemia is predictive of later atherosclerosis in SLE. In the general population, statins have become the drug of choice in preventing atherosclerotic events, through two mechanisms: lipid lowering that helps to prevent progression, and stabilization of plaques to prevent rupture. In the Lupus Atherosclerosis Prevention Trial we will determine if atorvastatin reduces the progression of atherosclerosis assessed using helical CT and carotid duplex. Recent work has confirmed that statins have an immunomodulatory role. This study will also determine whether statins improve clinical lupus activity or lupus serologies (anti-dsDNA and complement). This clinical trial will compare atorvastatin 40 mg vs placebo with the outcome being new or progressive atherosclerotic plaque measured on carotid duplex. Another outcome will be carotid intimal medial thickness, a surrogate variable for atherosclerosis. We will evaluate the effect of statin therapy on coronary calcium score using helical CT. The final aim is to determine which risk factors, traditional cardiovascular risk factors, lupus activity, antiphospholipid antibodies, and other prothrombotic factors best predict atherosclerosis in SLE. We propose to enroll 200 completed subjects who will be followed for 2 years. An amendment has been submitted to the IRB to increase the number of subjects to the number that will be recruited to provide 200 completed. The Cardiovascular Core Lab was utilized for this protocol.