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Updated: Aug 10, 2026
Skin Biopsy for Diagnosing Discoid Lupus Erythematosus
Published on: June 10, 2025
Cardiovascular involvement in systemic lupus erythematosus: an autopsy study of 27 patients in India
L Panchal1, S Divate, P Vaideeswar
1Department of Pathology, Seth G. S. Medical College, K.E.M. Hospital, Parel, Mumbai-400 012, India.
Insights
Cardiovascular disease (CVD) significantly contributes to mortality in Indian patients with systemic lupus erythematosus (SLE), second only to renal disease. Autopsy findings reveal common cardiac and vascular lesions in SLE patients.
Area of Science:
- Cardiology
- Rheumatology
- Pathology
Background:
- Cardiovascular disease (CVD) is a major cause of death in Western patients with systemic lupus erythematosus (SLE).
- Limited data exists on CVD prevalence and mortality in Indian SLE patients.
- This study addresses the data gap regarding cardiac and vascular complications in Indian SLE subjects.
Purpose of the Study:
- To determine the incidence of cardiac abnormalities and vascular lesions in Indian SLE patients via autopsy.
- To assess the contribution of these lesions to mortality in SLE patients.
- To correlate autopsy findings with clinical data and ante-mortem investigations.
Main Methods:
- Retrospective analysis of autopsy reports from 35 SLE patients over 11 years.
- Detailed examination of cardiac and vascular pathology in 27 cases with relevant lesions.
- Correlation of pathological findings with clinical history and investigations.
Main Results:
- Valvular lesions, including non-bacterial thrombotic endocarditis (33.33%), were most common.
- Myocarditis (37.03%) and myocardial scarring (25.92%) were frequently observed.
- Cardiovascular manifestations (29.62%) and renal disease (48.14%) were the primary causes of death.
Conclusions:
- Cardiovascular disease is a significant cause of mortality in Indian SLE patients.
- It ranks as the second leading cause of death, following renal disease.
- Autopsy findings highlight the critical role of cardiac and vascular pathology in SLE mortality.
Background:
Although cardiovascular disease (CVD) is recognized as a leading cause of death in patients with systemic lupus erythematosus (SLE) in western countries, there is hardly any data regarding Indian subjects with SLE.
Aims:
To determine the incidence of cardiac abnormalities and vascular lesions at autopsy and to assess their contribution to the mortality in patients with SLE.
Settings And Design:
Retrospective retrieval of reports of autopsies performed on 35 patients with SLE over a 11 year period and analysis of 27 cases with cardiac and/or vascular lesions.
Materials And Methods:
Gross and microscopic features in 27 autopsies were analyzed with special attention to the heart and the vasculature of all organs. Findings were correlated with clinical features and ante-mortem investigations. Their contribution towards mortality was assessed.
Results:
Valvar lesions were the commonest cardiac lesions noted with non-bacterial thrombotic endocarditis in nine (33.33%), valvar thickening in two (7.41%), Libman-Sacks endocarditis and infective endocarditis in one (3.70%) each. Myocarditis and myocardial scarring were seen in 10 (37.03%) and seven (25.92%) cases, respectively. Fibrinous pericarditis was noted in seven (25.92%). Thromboses/embolism, vasculitis and severe coronary atherosclerosis were seen in nine (33.33%), five (18.52%) and one (3.70%) subjects, respectively. Renal disease [13, 48.14%] and cardiovascular manifestations [8, 29.62%] were the leading causes of death in our patient population.
Conclusion:
CVD contributes significantly to the mortality in patients with SLE in India. It is second only to renal disease in this regard.
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