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Atherosclerotic vascular events in a multinational inception cohort of systemic lupus erythematosus
Author(s) -
Urowitz M. B.,
Gladman D.,
Ibañez D.,
Bae S. C.,
SanchezGuerrero J.,
Gordon C.,
Clarke A.,
Bernatsky S.,
Fortin P. R.,
Hanly J. G.,
Wallace D. J.,
Isenberg D.,
Rahman A.,
Alarcón G. S.,
Merrill J. T.,
Ginzler E.,
Khamashta M.,
Nived O.,
Sturfelt G.,
Bruce I. N.,
Steinsson K.,
Manzi S.,
RamseyGoldman R.,
Dooley M. A.,
Zoma A.,
Kalunian K.,
Ramos M.,
Van Vollenhoven R. F.,
Aranow C.,
Stoll T.,
Petri M.,
Maddison P.
Publication year - 2010
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20122
Subject(s) - medicine , cohort , myocardial infarction , cardiology , unstable angina , angina , stroke (engine) , vascular disease , heart failure , coronary artery disease , mechanical engineering , engineering
Objective To describe vascular events during an 8‐year followup in a multicenter systemic lupus erythematosus (SLE) inception cohort and their attribution to atherosclerosis. Methods Clinical data, including comorbidities, were recorded yearly. Vascular events were recorded and attributed to atherosclerosis or not. All of the events met standard clinical criteria. Factors associated with atherosclerotic vascular events were analyzed using descriptive statistics, t ‐tests, and chi‐square tests. Stepwise multivariate logistic regression was used to assess the association of factors with vascular events attributed to atherosclerosis. Results Since 2000, 1,249 patients have been entered into the cohort. There have been 97 vascular events in 72 patients, including: myocardial infarction (n = 13), angina (n = 15), congestive heart failure (n = 24), peripheral vascular disease (n = 8), transient ischemic attack (n = 13), stroke (n = 23), and pacemaker insertion (n = 1). Fifty of the events were attributed to active lupus, 31 events in 22 patients were attributed to atherosclerosis, and 16 events were attributed to other causes. The mean ± SD time from diagnosis to the first atherosclerotic event was 2.0 ± 1.5 years. Compared with patients followed for 2 years without atherosclerotic events (n = 615), at enrollment, patients with atherosclerotic vascular events were more frequently white, men, older at diagnosis of SLE, obese, smokers, hypertensive, and had a family history of coronary artery disease. On multivariate analysis, only male sex and older age at diagnosis were associated factors. Conclusion In an inception cohort with SLE followed for up to 8 years, there were 97 vascular events, but only 31 were attributable to atherosclerosis. Patients with atherosclerotic events were more likely to be men and to be older at diagnosis of SLE.