A study has estimated the frequency of cardiovascular events that occurred after diagnosis in a large Spanish cohort of patients with systemic lupus erythematosus ( SLE ) and has investigated the main risk factors for atherosclerosis.
RELESSER is a nationwide multicenter, hospital-based registry of SLE patients. This is a cross-sectional study. Demographic and clinical variables, the presence of traditional risk factors, and cardiovascular events were collected.
A cardiovascular event was defined as a myocardial infarction, angina, stroke, and/or peripheral artery disease.
From 2011 to 2012, 3658 SLE patients were enrolled. Of these, 374 ( 10.9% ) patients suffered at least a cardiovascular event.
In 269 ( 7.4% ) patients, the cardiovascular events occurred after SLE diagnosis ( 86.2% women, median [ interquartile range ] age 54.9 years [ 43.2-66.1 ], and SLE duration of 212.0 months [ 120.8-289.0 ] ).
Strokes ( 5.7% ) were the most frequent cardiovascular event, followed by ischemic heart disease ( 3.8% ) and peripheral artery disease ( 2.2% ).
Multivariate analysis identified age ( odds ratio [ 95% confidence interval ], 1.03 [ 1.02-1.04 ] ), hypertension ( 1.71 [ 1.20-2.44 ] ), smoking ( 1.48 [ 1.06-2.07 ]), diabetes ( 2.2 [ 1.32-3.74 ] ), dyslipidemia ( 2.18 [ 1.54-3.09 ] ), neurolupus ( 2.42 [ 1.56-3.75 ] ), valvulopathy ( 2.44 [ 1.34-4.26 ] ), serositis ( 1.54 [ 1.09-2.18 ] ), antiphospholipid antibodies ( 1.57 [ 1.13-2.17 ] ), low complement ( 1.81 [ 1.12-2.93 ] ), and Azathioprine ( 1.47 [ 1.04-2.07 ] ) as risk factors for cardiovascular events.
The study has confirmed that SLE patients suffer a high prevalence of premature cardiovascular disease. Both traditional and nontraditional risk factors contribute to this higher prevalence.
Although it needs to be verified with future studies, this study has also shown - for the first time - an association between diabetes mellitus and cardiovascular events in patients with systemic lupus erythematosus. ( Xagena )
Fernández-Nebro A et al, Medicine ( Baltimore ) 2015; 94(29):e1183. doi: 10.1097/MD.0000000000001183.