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Background: Peripheral arterial disease is a chronic complication that affects morbidity and mortality in SLE patient. However, there were only a few of researches studying the relationship of disease duration and  peripheral arterial disease event overseas and it has
never been studied in Indonesia.

Objectives: To obtain information about the increased event of peripheral arterial disease in women of 40 years old or younger with SLE’s duration of five years or longer compared with less than five years.

Methods: This was a case control study conducted between June - August 2012 at Cipto Mangunkusumo hospital, Jakarta. Subjects were women of 40 years old or younger with SLE who visited Rheumatolgy and Allergy-Immunlogy outpatient clinic. They were assigned
to case and control groups and traced retrospectively using interview and medical record. The relationship between disease duration and peripheral arterial disease was estimated using OR and the role of confounding factors was analysed using logistic regression one by
one, resulted in fully adjusted OR.

Results: A total of 90 subjects were recruited, 18 subjects in case group and 72 subjects in control group.Traditional risk factors were similiar in both groups. In multivariat analysis, there was a relationship between disease duration 5 years or longer and peripheral arterial
disease with fully adjusted OR 1,9 (95%CI 0,575-6,543). Older age and steroid therapy were the confounding factors.

Conclusion: There was an increased event of peripheral arterial disease in women of 40 years old or younger with SLE’s duration five years or longer compared with
subjects having the disease duration less than five years, but this increase was not statistically significant.

Keywords: Peripheral arterial disease, lupus erythematosus systemic, disease duration

Article Details

How to Cite
Merlyn, M., Setyohadi, B., Soebardi, S., & Harimurti, K. (2018). The effect of disease duration on the incidence of peripheral arterial disease in young adults with systemic lupus erythematosus. Indonesian Journal of Rheumatology, 4(1).


  1. Gordon C. Long – term complication of systemic lupus erythematosus. Rheum. 2002;41:1095-1100
  2. Urowitz MB, Bookman AAM, Koehler BE, Gordon DA, Smythe HA, Orgyzlo MA. The bimodal mortality pattern of SLE. Am J med. 1976;60:221-5
  3. Manzi S, Selzer F, Tyrrell KS, Fitzgerald SG, Rairie JE, Tracy RP, dkk. Prevalence and risk factors of carotid plaque in woman with
  4. systemic lupus erythematosus and antiphopholipid syndrome. Rheum. 2005;44:756-61
  5. Shoenfeld Y, Gerli R, Doria A, Matsuura E, Cerinic MM, Ronda N, dkk. Accelerated atherosclerosis in autoimmune rheumatic diseases. Circ.2005;112:3337-45
  6. Doria A, Schoenfeld Y, Wu R, Gambari P, Puato M, Ghiraraello A, dkk. Riskfactors for subclinical atherosclerosis in a prospective cohort of patients with systemic lupus erythematosus. Ann Rheum Dis. 2003;62(11):1071-7
  7. Esdaile JM, Abrahamwicz M, Grodzizky T, Li Y, Panaritis C, Berger RD, dkk. Traditional Framingham risk factor fail to fully account for accelerated atherosclerosis in systemic lupus erythematosus. Arthritis Rheum.2001;44:2331-7
  8. Kaplan MJ. Premature vascular damage in systemic lupus erythematosus: an imbalance of damage and repair?. Trans Res. 2009;154 (2):61-6
  9. Schattner A. The cardiovasculer burden of lupus. Arch intern med. 2003;163:1507-10
  10. Peripheral arterial disease. Dalam: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editor. Harrison’s principle of internal medicine. Edisi 17. New York: McGraw-Hill; 2008:243
  11. Golomb BA, Dang TT, Criqui MH. Peripheral arterial disease. Morbidity and mortality implications. Circ. 2006;114:688-99
  12. Theodoridou A, Bento L, D’Cruz DP, Khamashta MA, Hughes GRV. Prevalence and associations of an abnormal ankle-brachial index in systemic lupus erythematosus: a pilot study. Ann Rheum Dis.2003;62:1119-1203
  13. Burgos PI, Vila LM, Reveille JD, Alarcon GS. Peripheral vascular damage in systemic lupus erythematosus: data from LUMINA, a large multiethnic U.S cohort (LXIX). Lupus. 2009;18:1303-8
  14. Bhatt SP, Handa R, Gulati GS, Sharma S, Pandey RM, Anggarwai P, et al. Peripheral vascular disease in systemic lupus erythematosus. Lupus.2007;16:720-3
  15. Wang CR, Chou CC, Hsieh KH, Chuang CH, Chen CY. Lupus patientwith peripheral vascular thrombosis: the significance of measuring anticardiolipin antibody. Am J Emerg Med. 1993;11:468-70
  16. Sari RM, Prevalensi Kejadian Ateroskleoris dan Korelasi antara Faktor Risiko Aterosklerosis terhadap Tebal Kompleks Intima Media Arteri Karotis Penderita Lupus Eritematosus Sistemik (LES) Wanita yang Berusia di bawah 40 Tahun [Tesis]. Jakarta: Universitas Indonesia; 2009.
  17. Kornitzer M, Dramaix M, Sobolski J, Degre S, De Backer G. Ankle/arm pressure index in asymptomatic middle-aged males: an independent predictor of ten-year coronary heart disease mortality. Angiology. 1995;46:211–9
  18. Liu A, Zhang W, Tian X, Zhang X, Zhang F, Zeng X. Prevalence, risk factors and outcome of digital gangrene in 2684 lupus patients. Lupus. 2009;18:1112-18
  19. Roman MJ, Shanker BA, Davis A, Lockshin MD, Sammaritano L, Simantov R, dkk. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N engl J Med. 2003; 349:2399-406
  20. Kahlenberg JM, Kaplan MJ. The interplay of of inflammation and cardiovascular disease in systemic lupus erythematosus. Arthritis research & therapy. 2011;13:203-13
  21. McMahoon M, Grossman J. Pathogenesis of atherosclerosis in Lupus. Dalam: JW Daniel, HH Bevr, eds. Dubois Lupus Erythematosus. Edisi 7. Philadelphia. Lipincott Williams&Wilkins;2007:356-66
  22. Norman PE, Eikelboom JW, Hankey GJ. Peripheral arterial disesase: prognostic significance and prevention of atherothrombotic complications. MJA. 2004;181:150-4
  23. McDermott MM, Fried L, Simonsick E, Ling S, Guralnik JM. Asimptomatik peripheral arterial disesase is independently associated with impaired lower extremity functioning. The women’s health and aging study. Circ. 2000;101:1007-12
  24. Hooi JF, Kester ADM, Stoffers HEJH, Rinkens PELM, Knottnerus JA, VanRee JW. Asymptomatic peripheral arterial occlusive disease predicted cardiovasculer morbidity and mortality in a 7-year follow-up study. Journal of clin epid. 2004;57:294-300
  25. Petri M, Lakatta C, Magder L, Goldman D. Effect of prednison and hydroxychloroquine on coronary artery disease risk factor in systemic
  26. lupus erythematosus: a longitudinal data analysis. Am J Med. 1994;96:254
  27. McDonald J, Stewart J, Urowitz MB, Gladman DD. Peripheral vascular disease in patients with systemic lupus erythematosus. Ann Rheum Dis. 1992;51:56-60
  28. Willenberg T, Diehm N, Zwahlen M, Kalka C, Do DD, Gretener S, dkk. impact of long-term corticosteroid therapy on the distribution pattern of lower limb atherosclerosis. Eur J Vasc Endovasc Surg. 2010:39;441-6