Table 1.

Patient characteristics and case description

	Cardiac symptoms
Demographics	CVD risk factors	SLE characteristics	Laboratory data	ECG, echo and coronary evaluation (CAC or catheterisation)	Cardiac FDG PET findings	Treatment and follow -up (f/u)
32-year-old male Hispanic	No symptoms Never smoker	SLE × 5 years h/o NPSLE SLEDAI-2K=1 SDI=0 ANA, SSA, SSB, DNA on HCQ	C3—87; C4—28; DNA—25; ESR—11 CRP—3.5; Trop<0.01; Pro-BNP—NA	ECG—sinus tachycardia; Echo—EF 56%; CAC—17	Diffuse FDG myocardial uptake	Prednisone 1 mg/kg, MMF 3 g/day 6-month f/u echo: EF 60%
31-year-old female Hispanic	Chest pain, palpitations Former smoker	SLE × 11 years h/o LN SLEDAI-2K=4 SDI=0 ANA, SSA, SSB, DNA on HCQ	C3—91; C4—14; DNA—9.9; ESR—7; CRP—0.4; Trop<0.01; Pro-BNP—41	ECG—sinus tachycardia, RBBB; Echo—EF 60%; CAC—0	Diffuse FDG myocardial uptake	Prednisone 1mg/kg, MMF 3 g/day 6-month f/u echo: EF 60%
55-year-old female African American	Chest pain Former smoker, h/o lupus pericarditis	SLE × 16 years h/o LN SLEDAI-2K=9 SDI=1 ANA, DNA on HCQ	C3—71; C4—10.5; DNA—38.8; ESR—6; CRP—85; Trop<0.01; Pro-BNP—820	ECG—sinus tachycardia, non-specific ST-T changes; Echo—EF 20%, pericardial effusion, valvular abnormalities; Catheterisation—non-obstructive CAD	Diffuse FDG myocardial uptake	Methylprednisolone 1 g/day ×3 days, then prednisone 1 mg/kg Other—Metoprolol, carvedilol, valsartan 8-month f/u echo: EF 60%
67-year-old male African American	Shortness of breath Never smoker, HTN, DM	SLE × 20 years SLEDAI-2K=2 SDI=5 ANA, SSA on HCQ	C3—91; C4—26; DNA— <6.0; ESR— 596; CRP—19.6; Trop<0.01; Pro-BNP—NA	ECG—non-specific ST-T changes, RBBB; Echo—EF 30%, global hypokinesis, LV dilatation; Catheterisation—angiographically normal coronary arteries	Diffuse FDG myocardial uptake	Prednisone 1 mg/kg, MMF 3 g/day Other- carvedilol, amlodipine, valsartan, rosuvastatin, aspirin 13-month f/u cardiac FDG PET: EF 35%, diffuse FDG myocardial uptake decreased by 3 SUV units
35-year-old female Hispanic	No symptoms Never smoker	SLE x 2 years SLEDAI-2K=2 SDI=0 ANA, SSA, DNA on HCQ	C3—140; C4—33; DNA—60.7; ESR—29; CRP—2.6; Trop<0.01; Pro-BNP—NA	ECG—sinus tachycardia; Echo—EF 55%; CAC—0	Diffuse FDG myocardial uptake	Prednisone 1 mg/kg, MMF 3 g/day 5-month f/u cardiac FDG PET: No FDG uptake. EF 62%
47-year-old female African American	Shortness of breath Never smoker	SLE × 17 years h/o LN SLEDAI-2K=18 SDI=2 ANA, DNA, Sm, RNP On HCQ	C3—62; C4—11; DNA—192.8; ESR—25; CRP—0.3; Trop<0.01; Pro-BNP—10235	ECG—non-specific ST-T changes; Echo—EF 20%, global hypokinesis, left atrial enlargement; Catheterisation—angiographically normal coronary arteries	Diffuse FDG myocardial uptake	Prednisone 1 mg/kg, MMF 3 g/day. Other—carvedilol, nifedipine, aspirin, atorvastatin. Lost to follow-up
37-year-old female African American	Chest pain Never smoker	SLE × 9 years h/o LN SLEDAI-2K=12 SDI=2 ANA, DNA, Sm, RNP On HCQ	C3—52; C4—0; DNA—1098.2; ESR—52; CRP—12; Trop—0.75; Pro-BNP—NA	ECG—non-specific ST-T changes; Echo—EF 40%, wall motion abnormality, pericardial effusion; Catheterisation—mid LAD 70% occlusion and 100% D1 occlusion	Diffuse FDG myocardial uptake	Prednisone 1mg/kg, Cyclophosphamide 500mg/m2 intravenous monthly Other—carvedilol, hydralazine, isosorbide mononitrate, aspirin, atorvastatin 6-month f/u echo: EF 50%, impaired LV relaxation. No wall motion abnormality
42-year-old female Hispanic	Chest pain Current smoker	SLE × 7 years SLEDAI-2K=6 SDI=0 ANA, SSA, SSB, DNA, Sm On HCQ	C3—82; C4—12; DNA—130.1; ESR—77; CRP—0.6; Trop<0.01; Pro-BNP—NA	ECG—sinus tachycardia, non-specific ST-T changes; Echo—EF 50%, pericardial effusion, valvular abnormality; CAC—0	Diffuse FDG myocardial uptake	Prednisone 1 mg/kg, MMF 3 g/day Other—metoprolol, atorvastatin 6-month f/u echo: EF 55%, impaired LV relaxation

Reference values: DNA≤24.9 IU/mL; C3 (80–162 mg/dL); C4 (14–47 mg/dL); ESR (0–20 mm/hour); CRP (<10 mg/L); Troponin<0.01 ng/mL; pro-BNP<178 pg/mL.

ANA, antinuclear antibody; CAC, coronary artery calcium; CAD, coronary artery disease; CRP, C reactive protein; CVD, cardiovascular disease; D1, first diagonal branch. DNA, anti-ds-DNA antibody; ECG, electrocardiogram; Echo, echocardiogram; EF, ejection fraction; ESR, erythrosedimentation rate; FDG PET, fluorodeoxyglucose positron emission tomography; HCQ, hydroxychloroquine; h/o, history of; LAD, left anterior descending artery; LN, lupus nephritis; LV, left ventricle; MMF, mycophenolate mofetil; NA, not available; NPSLE, neuropsychiatric SLE; pro-BNP, pro-beta natriuretic peptide; RBBB, right bundle branch block; RNP, anti-ribonucleoprotein antibody; SDI, Systemic Lupus International Collaborating Clinics (SLICC) damage index for SLE; SLE, systemic lupus erythematosus; SLEDAI-2K, SLE Disease Activity Index 2000; Sm, anti-Smith antibody; SSA, anti-SSA antibody; SSB, anti-SSB antibody; SUV, standardised uptake values; Trop, troponin.