The objective of the study was to evaluate anti-apolipoprotein A-I (Apo A-I) and carotid intima-media thickness (cIMT) as cardiovascular risk factors in Egyptian women with systemic lupus erythematosus (SLE). The study included 160 subjects, 80 women with SLE and 80 healthy women as a control group. Disease activity score (SLEDAI), disease damage index (SLICC/ACR), lipid profile, complement C3 and C4, high-sensitivity CRP (hsCRP), anti-dsDNA and anticardiolipin antibodies were evaluated in addition to anti-Apo A-I antibodies and cIMT. The mean age of patients was 28.35 ± 7.06 years with mean disease duration of 4.58 ± 3.36 years. Anti-Apo A-I antibody titer was significantly higher in SLE patients than in controls (mean 35.3 ± 6.8 vs. 21.4 ± 5.91 U/L; P = 0.000). Carotid ultrasound showed significantly thickened intima in SLE patients compared with control subjects (mean thickness, 0.5 ± 0.08 vs. 0.45 ± 0.06 mm; P = 0.003). Correlation studies with other cardiovascular risk factors demonstrated significant associations between anti-Apo A-I and SLEDAI, SLICC/ACR, C3 and C4. On the other hand, cIMT showed significant association with age, systolic blood pressure, hsCRP and body mass index. Thus, SLE disease activity is associated with a significant increase in anti-Apo A-I titer. Also, increased cIMT might be a cardiovascular risk factor in Egyptian patients with SLE. [ABSTRACT FROM AUTHOR]