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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Mortality related to cerebrovascular disease in systemic lupus erythematosus

S Bernatsky1, A Clarke, D D Gladman

  • 1Division of Clinical Epidemiology, Montreal General Hospital, Montreal, Quebec, Canada.

Lupus
|January 11, 2007
PubMed

Insights

Systemic lupus erythematosus (SLE) patients face double the risk of death from cerebrovascular disease compared to the general population. This increased risk, particularly for ill-defined events, highlights a critical area for further research in SLE patient care.

Area of Science:

  • Neurology
  • Rheumatology
  • Epidemiology

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with known associations to cardiovascular complications.
  • Cerebrovascular disease (CVD) is a significant cause of morbidity and mortality, but its specific impact in SLE patients requires further elucidation.

Purpose of the Study:

  • To investigate and quantify the mortality rates associated with cerebrovascular disease in a Canadian cohort of SLE patients.
  • To compare these mortality rates against those observed in the general population.

Main Methods:

  • Utilized a multisite Canadian SLE cohort comprising 2688 patients.
  • Ascertained deaths due to cerebrovascular disease through vital statistics registry linkage using International Classification of Diseases (ICD) codes.
  • Calculated standardized mortality ratios (SMR) to compare observed versus expected deaths.

Main Results:

  • The overall standardized mortality ratio (SMR) for cerebrovascular disease death in SLE patients was 2.0 (95% CI 1.0, 3.7), indicating a doubled risk.
  • Significantly elevated SMRs were observed for ill-defined cerebrovascular events (SMR 44.9) and other cerebrovascular diseases (SMR 8.4).
  • Cerebral hemorrhages and other cerebrovascular events appeared more common causes of death than cerebral infarctions.

Conclusions:

  • Mortality related to cerebrovascular disease is increased in SLE patients compared to the general population.
  • The high SMR for ill-defined cerebrovascular events may suggest undiagnosed cerebral vasculitis or diagnostic challenges in SLE.
  • Factors such as thrombocytopenia or anticoagulation may contribute to the higher incidence of cerebral hemorrhage in SLE patients.

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