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Eventos vasculares en clústeres definidos por autoanticuerpos de lupus eritematoso sistémico: un estudio de cohorte

Sara Ferrigno^1,2, Elizabeth V Arkema³, Iva Gunnarsson¹

¹Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Rheumatology (Oxford, England)

|February 12, 2026

Abstracto

Objectives:

We recently identified four Systemic lupus erythematosus (SLE) clusters based on 13 autoantibodies used in clinical practice. In this prospective cohort study, we investigate the incidence of major cardiovascular events (MACE) and venous thromboembolism (VTE) in SLE patients stratified by clusters. Clusters were compared with each other and to matched controls.

Methods:

Clusters were defined at baseline: Cluster 1 dominated by anti-SSA/SSB, Cluster 2 by anti-nucleosome/Sm/RNP/dsDNA, Cluster 3 by aPL, and Cluster 4 negative for all 13 autoantibodies. SLE clinical data were collected at enrolment. Vascular outcomes were prospectively retrieved from the National Patient Register using ICD codes. Each patient was matched on birth/sex/residence to 10 controls from the Total Population Register. Subjects with previous vascular events were excluded. Hazard ratios (HR) and 95% confidence intervals from Cox proportional hazards models estimated the age-adjusted relative risks of incident vascular events.

Results:

We included 461 SLE patients, mean follow-up 12.2 ± 5.6 years. Compared with reference clusters, Cluster 3 (n = 154) had the highest relative risk for MACE (HR 1.91 (95%CI: 1.01-3.58) and VTE (HR 2.69 (95%CI: 1.05-6.9). Cluster 2 (n = 105) had high risk for heart failure and VTE, similar to cluster 3, despite younger age. The lowest incidence of vascular events was observed in cluster 4 (n = 61) in comparison to the other clusters.

Conclusions:

We observed differences regarding the incidence of MACE and VTE during 12 years of follow up for four autoantibodydefined clusters. The highest incidences were seen in the aPL-dominated cluster, while the lowest were detected in the autoantibody-negative cluster.

Palabras clave:

Lupus eritematoso sistémico autoanticuerpos eventos cardiovasculares análisis de clústeres tasa de incidencia eventos tromboembólicos

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