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Prevalence, predictors and outcome of vascular damage in systemic lupus erythematosus

A Becker-Merok1, Jc Nossent

  • 1Department of Rheumatology, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway. Andrea.Becker-Merok@unn.no

Lupus
|April 28, 2009
PubMed

Insights

Systemic lupus erythematosus (SLE) patients face a high risk of vascular events (VE), primarily atherothrombotic, increasing mortality risk four-fold. Managing disease activity with antimalarials and antihypertensives may reduce these risks.

Area of Science:

  • Rheumatology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Systemic lupus erythematosus (SLE) patients have a higher risk of premature death, with vascular events (VE) being a significant contributor.
  • Conventional cardiovascular risk factors do not fully account for the increased VE risk in SLE patients.

Purpose of the Study:

  • To investigate the contribution of SLE-specific factors to the development of vascular events.
  • To analyze the types of VE and their association with disease activity, damage, and treatment in SLE.

Main Methods:

  • A longitudinal study of 158 SLE patients in the Tromsø Lupus cohort with a mean follow-up of 12 years.
  • Vascular events were classified, and disease-specific factors including organ manifestations, laboratory findings, drug treatment, SLE Disease Activity Index (WAS), and cumulative Damage Index were assessed.
  • Multivariate analysis was used to determine odds ratios for VE.

Main Results:

  • 26% of SLE patients developed VE, predominantly atherothrombotic (73%).
  • VE prevalence was 3.5/100 patient-years, increasing linearly over time to 35% after 20 years.
  • Higher WAS scores (>3) increased VE risk, while hydroxychloroquine and antihypertensive use decreased it. Age >40 was a key risk factor for atherothrombotic events.

Conclusions:

  • Vascular events significantly increase mortality risk by nearly four-fold in SLE patients.
  • Atherothrombotic events are the most common type of VE in SLE.
  • Reducing SLE disease activity through treatments like antimalarials and antihypertensives is crucial for mitigating VE risk.

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