[Cardiovascular risk profile in systemic lupus erythematosus: a cross-sectional study of 879 patients]
Chao-sheng He1, Wei Shi, Zhi-ming Ye
1Department of Nephrology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou 510080, China. hcs_gz@139.com
Insights
Systemic lupus erythematosus (SLE) significantly increases cardiovascular disease (CVD) risk, particularly in older patients and those with lupus nephritis. Key risk factors include elevated blood pressure, reduced kidney function, and longer disease duration.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Context:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with significant cardiovascular implications.
- Cardiovascular diseases (CVD) represent a major cause of morbidity and mortality in SLE patients.
- Understanding the prevalence and risk factors for CVD in SLE is crucial for patient management.
Purpose:
- To determine the prevalence of cardiovascular diseases (CVD) in patients diagnosed with systemic lupus erythematosus (SLE).
- To identify and estimate the risk factors associated with the development of CVD in an SLE patient cohort.
- To analyze the correlation between CVD and clinical parameters such as age, lupus nephritis, and disease duration.
Summary:
- This cross-sectional study analyzed 879 SLE patients, revealing a 9.7% prevalence of CVD.
- CVD prevalence increased with age and was significantly higher in patients with lupus nephritis.
- Identified risk factors for CVD in SLE patients included higher systolic blood pressure (SBP), lower estimated glomerular filtration rate (eGFR), lower high-density lipoprotein (HDL) levels, longer SLE duration, higher SLE Disease Activity Index (SLEDAI), and elevated serum C3 and hs-CRP levels.
Impact:
- The findings highlight SLE as an independent risk factor for CVD, emphasizing the need for proactive cardiovascular risk assessment in these patients.
- Age and lupus nephritis are significant factors influencing CVD risk in SLE.
- The study provides a comprehensive list of modifiable and non-modifiable risk factors for CVD in SLE, guiding targeted interventions and future research.
Objective:
To investigate the prevalence of cardiovascular diseases (CVD) in patients with systemic lupus erythematosus (SLE) and estimate the associated risk factors for CVD.
Methods:
This cross-sectional study was conducted in 879 SLE patients treated in our hospital between March, 2006 and March, 2011. The demographic data and the clinical data including SLE duration, therapeutic regimen, renal pathological data, estimated glomerular filtration rate (eGFR), SLE Disease Activity Index (SLEDAI), and associated biochemical parameters were analyzed. Cardiovascular ultrasound was used for detecting and analyzing the cardiovascular structural and functional abnormalities.
Results:
Eighty-five cases of CVD were found in the 879 SLE cases (9.7%). After age stratification, CVD was identified in 5.8%, 9.0%, 14.0% and 20.0% in SLE patients aged ≤19, 20-39, 40-59 and ≥60 years, respectively, showing a tendency to increase with age (P=0.002). The prevalence of CVD differed significantly between patients with and those without lupus nephritis (P=0.001). Among the 85 patients with CVD, 23.5% (20/85) had left ventricular hypertrophy, 49.5% (42/85) had congestive heart failure, 20.0% (17/85) had stroke, 3.5% (3/85) had angina pectoris, and 3.5% (3/85) had peripheral CVD. Compared to those without CVD, patients with CVD had a longer SLE duration (P=0.002), a longer time of steroids treatment (P=0.026), a higher blood pressure (P=0.0006), a lower eGFR (P=0.001), and a lower concentration of HDL (P=0.007). Logistic regression analysis showed that SBP, eGFR, HDL, SLE duration, SLEDAI index, serum C3 and hs-CRP were the risk factors for CVD in SLE patients (P=0.033).
Conclusion:
SLE is associated with a high risk of CVD which increases with age, and SLE patients with lupus nephritis have an even higher risk for CVD. SBP, eGFR, HDL, SLE duration, SLEDAI index, serum C3 and hs-CRP are the risk factors for CVD in SLE patients.
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