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Morbidity and Mortality Associated With Systemic Lupus Erythematosus and Retinal Vasculitis: A Multicenter Cohort
Jennifer D Huang1, Kapil Mishra1, Karen Wai2
1Department of Ophthalmology, University of California School of Medicine, Irvine.
Insights
Patients with systemic lupus erythematosus (SLE) and retinal vasculitis (RV) face similar long-term risks of death, heart attack, and dialysis compared to those without RV. However, SLE/RV patients show an increased stroke risk over 5-10 years.
Area of Science:
- Rheumatology
- Ophthalmology
- Cardiology
- Nephrology
- Neurology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
- Retinal vasculitis (RV) is a serious ocular manifestation of SLE.
- Long-term outcomes for patients with SLE and RV require further investigation.
Purpose of the Study:
- To assess the long-term incidence of death, myocardial infarction (MI), dialysis, and stroke in patients diagnosed with SLE and RV.
- To compare these outcomes with matched cohorts without RV.
Main Methods:
- Utilized TriNetX, a federated electronic health records network, to identify 435 patients with SLE/RV from 2004 to 2024.
- Matched patients based on age, sex, race, and propensity score.
- Excluded patients with prior MI, dialysis, or cerebrovascular complications.
Main Results:
- No statistically significant differences in the risk of death, MI, or dialysis were observed between SLE/RV and control cohorts at 5 and 10 years.
- An increased risk of stroke was identified in the SLE/RV cohort at 5 and 10 years post-diagnosis.
- No significant difference in stroke risk was found at the 1-year mark.
Conclusions:
- Patients with SLE and RV share similar long-term risks for death, MI, and dialysis compared to those without RV.
- SLE/RV patients demonstrate an elevated risk of stroke in the 5-10 years following diagnosis.
- Multidisciplinary care is crucial for managing the increased stroke risk in SLE/RV patients.
Background And Objective:
To determine the long-term rates of death, myocardial infarction (MI), dialysis, and stroke in patients with systemic lupus erythematosus (SLE) and retinal vasculitis (RV).
Patients And Methods:
A total of 435 patients with SLE/RV were identified using TriNetX, a federated electronic health records network from January 1, 2004 to January 1, 2024. Patients were matched for age, sex, race, and propensity score, excluding those with MI, dialysis, or cerebrovascular complication in the year prior to diagnosis.
Results:
The risk of death, MI, and dialysis was not statistically different between cohorts at 5 and 10 years. The risk of stroke was increased at 5 and 10 years in the SLE/RV cohort, but no statistically significant difference in risk was found at 1 year.
Conclusion:
Although patients with and without RV may have similar long-term rates of death, MI, and dialysis, patients with SLE/RV may have an elevated risk of stroke in the subsequent 5 and 10 years after diagnosis, highlighting the need for multidisciplinary care.
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