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A Meta-Analysis of Cardiovascular Events in Systemic Lupus Erythematosus
Ming-Ming Gu1,2, Xue-Ping Wang1,2, Qian-Yao Cheng1,2
1a Department of Epidemiology and Health Statistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.
Insights
Patients with systemic lupus erythematosus (SLE) face a significantly higher risk of cardiovascular events, including myocardial infarction (MI) and stroke. This meta-analysis confirms elevated occurrence rates and risk compared to the general population.
Area of Science:
- Cardiology
- Rheumatology
- Epidemiology
Background:
- Systemic lupus erythematosus (SLE) is an autoimmune disease associated with increased cardiovascular (CV) risk.
- Understanding the precise incidence and risk of specific CV events like stroke and myocardial infarction (MI) in SLE patients is crucial for clinical management.
Purpose of the Study:
- To accurately identify the occurrence and risk of stroke and myocardial infarction (MI) in patients diagnosed with systemic lupus erythematosus (SLE).
Main Methods:
- A comprehensive systemic literature search was conducted using PubMed and additional manual searches up to March 31, 2018.
- Pooled incidences and risk ratios (RR) for MI and stroke in SLE patients compared to controls were calculated via meta-analysis.
Main Results:
- The meta-analysis of 24 studies revealed a MI incidence of 2.0% (0.20/100 person-years) in SLE patients, with a 3.04 times higher risk compared to the general population.
- Stroke incidence in SLE patients was 4.4% (0.44/100 person-years), and the risk was 1.95 times higher than in the general population.
- Data included over 96,000 individuals for MI and over 255,000 for stroke, with substantial follow-up periods.
Conclusions:
- Patients with systemic lupus erythematosus (SLE) exhibit a significantly elevated risk for cardiovascular events, specifically myocardial infarction and stroke.
- These findings underscore the importance of proactive cardiovascular risk assessment and management in the SLE population.
Abstract:
Objective: To identify accurate occurrence and risk of cardiovascular (CV) events (stroke and myocardial infarction [MI]) in patients with systemic lupus erythematosus (SLE). Methods: Systemic literature search in PubMed and additional manual search were performed to obtain interested studies until March 31, 2018. The pooled incidences and risk of stroke and MI were calculated. Results: A total of 24 studies were included in this meta-analysis. For MI, a total of 1,516 SLE patients were reported to had MI (n = 96,154) over a mean follow-up of 9.98 years: incidence 2.0% (95% CI: 1.7-2.4%), i.e. 0.20/100 pyrs; in the five studies, 360 SLE patients (n = 18,943) and 817 controls had MI (n = 111,525), revealing that the risk of MI in SLE population was 3.04 times higher than in the general population (RR = 3.04, 95% CI: 1.81-5.11). For stroke, the incidence of 17 studies during the 10.09 follow-up period using random model was 4.4% (95% CI: 3.6-5.1%), i.e. 0.44/100 pyrs; in the 7 studies, 694 SLE patients (n = 22,594) and 4,034 controls had stroke (n = 255,023), indicating that the risk of MI in SLE population was 1.95 times higher than that in the general population (RR = 1.95, 95% CI: 1.52-2.53). Conclusion: Based on the findings from previous reports, our meta-analysis showed that patients with SLE have been at higher risk of CV events.
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