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Predictors of the first cardiovascular event in patients with systemic lupus erythematosus - a prospective cohort

Johanna Gustafsson1, Iva Gunnarsson, Ola Börjesson

  • 1Rheumatology Unit, Department of Medicine Karolinska University Hospital, Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden. johanna.gustafsson@karolinska.se

Arthritis Research & Therapy
|December 17, 2009
PubMed

Insights

Cardiovascular events (CVEs) in Systemic lupus erythematosus (SLE) patients are predicted by age, positive antiphospholipid antibodies (aPL), and markers of endothelial activation. Absence of thrombocytopenia also indicates higher CVE risk in SLE patients.

Area of Science:

  • Rheumatology
  • Cardiology
  • Immunology

Background:

  • Cardiovascular disease (CVD) is a leading cause of premature death in Systemic lupus erythematosus (SLE) patients.
  • Prospective studies evaluating risk factors for hard cardiovascular events (CVEs) in SLE are limited.

Purpose of the Study:

  • To investigate traditional and SLE-associated risk factors for the first occurrence of CVEs in a longitudinal SLE cohort.

Main Methods:

  • 182 SLE patients without prior CVEs were followed for a mean of 8.3 years.
  • Baseline cardiovascular and autoimmune biomarkers, clinical information, and SLE manifestations were assessed.
  • Cox regression analysis was used to evaluate predictors of first CVE.

Main Results:

  • 13% of patients experienced a first CVE.
  • Predictors included age, positive antiphospholipid antibodies (aPL), elevated endothelial activation markers (von Willebrand factor, sVCAM-1), and fibrinogen.
  • Absence of thrombocytopenia, arthritis, pleuritis, and previous venous occlusion were also associated with CVE risk.

Conclusions:

  • Age, positive aPL, endothelial activation markers, and absence of thrombocytopenia are independent predictors of CVEs in SLE.
  • Endothelial activation and coagulation system activation are key in SLE-related CVD.
  • CVE risk may vary among different SLE patient subgroups.
Abstract

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