Aortic aneurysm and dissection in systemic lupus erythematosus

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Surgery

Background:

• Aortic aneurysm and dissection are rare but serious complications of systemic lupus erythematosus (SLE).
• Limited data exists on the incidence, etiology, risk factors, and outcomes of these vascular events in SLE patients.
• Understanding these factors is crucial for timely diagnosis and management.

Purpose of the Study:

• To investigate the incidence, risk factors, and outcomes of aortic aneurysm and dissection in patients with systemic lupus erythematosus.
• To synthesize current knowledge from published literature on this rare complication.

Main Methods:

• A systematic literature review was conducted, analyzing 36 articles published between 2000 and 2017.
• Data from 40 patients diagnosed with SLE-related aortic aneurysm or dissection were collected and analyzed.
• Demographic, clinical, treatment, and outcome data were extracted.

Main Results:

• The study identified an absolute female predominance in affected patients, with a mean age of 44.6 years at diagnosis.
• Long-term steroid use (mean 13.3 years) and hypertension were identified as predominant risk factors.
• Abdominal aortic aneurysms were more common than dissections, which showed no location predilection. Open surgical repair had a higher mortality rate, though not statistically significant.

Conclusions:

• Systemic lupus erythematosus significantly increases the risk of aortic aneurysm and dissection.
• Hypertension, prolonged steroid use, and SLE-related aortic pathology are key risk factors.
• Prompt diagnosis and appropriate management, including surgical, interventional, or hybrid approaches, are essential to prevent mortality and severe complications.