Ve new plaque progression and a higher mean IMT at followup. They also had a higher rate of change in IMT per year and a higher mean number of new plaques per year (Table 6). Multivariate analyses for predictors of plaque progression in SLE included the significant predictors identified on univariate analysis, potential confounders, and the baseline presence of carotid plaque. The only variable that remained significantly associated with carotid plaque progression using logistic regression was a high PREDICTS score, with an OR of 15.5 (95 CI 5.35.3, P 0.001). The high-risk PREDICTS profile was also significantly associated with the mean change in IMT per year in SLE patients, as determined using linear regression (P = 0.004). Five subjects in our cohort experienced a documented incident cardiovascular event, and 17 experienced a cerebrovascular event; all of these events occurred in patients with SLE.Arthritis Rheumatol. Author manuscript; available in PMC 2014 July 22.McMahon et al.PageAmong the 5 SLE patients who had a cardiovascular event, all had a high baseline PREDICTS score (P = 0.01). Nine of the 17 patients with a cerebrovascular event had a high baseline PREDICTS score (P not significant).NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptDISCUSSIONWe found that the PREDICTS panel of 4 inflammatory biomarkers and 2 traditional cardiac risk factors (age and diabetes), as compared with individual bio-markers or risk factors, had overall better predictive capacity for the presence, progression, or acquisition of carotid artery plaque in SLE patients who were followed up for 2 years.Sotagliflozin The PREDICTS profile also demonstrated a better predictive capacity than a panel of traditional cardiac risk factors. Thus, PREDICTS is a good instrument for identifying SLE patients at increased risk of developing ATH in our cohort. Future studies will be needed to validate PREDICTS in other lupus cohorts. Multiple recent studies in individuals from the general population without any history of CVD showed that the addition of nonstandard markers (including lipid-related markers and measures of inflammation, endothelial function, fibrinolysis, and oxidant stress) to risk scores containing standard cardiac risk factors led to only slight improvement in the prediction of cardiovascular events (358) or progression of subclinical ATH (39).Tiotropium Bromide It may be, however, that novel biomarkers have a greater impact on risk prediction in higher-risk populations and in populations in whom alternate pathways play a more important role in the pathogenesis of disease than traditional risk factors; thus, PREDICTS might be used to identify risk more effectively in higher-risk populations such as patients with SLE.PMID:24458656 Our finding that a panel combining inflammatory biomarkers and select traditional risk factors is more predictive of subclinical ATH than are traditional risk factors alone supports the hypothesis that inflammatory processes play a vital role in the development of ATH in SLE. PREDICTS was surprisingly also significantly predictive of subclinical ATH in our female control subjects. Although these results are intriguing, larger and longer studies are necessary to determine how accurately PREDICTS assesses cardiovascular risk in both the general population and SLE populations. Each of the biomarkers identified in the PREDICTS profile has been linked to both SLE and CVD in the non-lupus population. These markers also appear to be direct contri.