Key result
Systemic lupus erythematosus was associated with a higher 10-year risk of heart failure than controls (3.71% vs 1.94%), and higher mortality following HF diagnosis (HR 1.50; 95% CI 1.08-2.08).
Why the study?
Does systemic lupus erythematosus increase the long-term risk of cardiovascular outcomes and heart failure mortality in patients without prior cardiovascular disease?
Cohort (n=17,055)
Does systemic lupus erythematosus increase the long-term risk of cardiovascular outcomes and heart failure mortality in patients without prior cardiovascular disease?
Systemic lupus erythematosus is associated with a significantly increased long-term risk of incident heart failure and other cardiovascular outcomes, as well as higher mortality once heart failure develops.
BACKGROUND Data on long-term cardiovascular outcomes in systemic lupus erythematosus (SLE) are sparse. OBJECTIVES This study sought to examine the long-term risk and prognosis associated with cardiovascular outcomes, including heart failure (HF), in patients with SLE. METHODS Using Danish administrative registries, risks of outcomes were compared between SLE patients (diagnosed 1996 to 2018, no history of cardiovascular disease) and age-, sex-, and comorbidity-matched control subjects from the background population (matched 1:4). Furthermore, mortality following HF diagnosis was compared between SLE patients developing HF and age- and sex-matched non-SLE control subjects with HF (matched 1:4). RESULTS A total of 3,411 SLE patients (median age: 44.6 years [25th to 75th percentile: 31.9 to 57.0 years]; 14.1% men) were matched with 13,644 control subjects. The median follow-up was 8.5 years (25th to 75th percentile: 4.0 to 14.4 years). Absolute 10-year risks of outcomes were: HF, 3.71% (95% confidence interval [CI]: 3.02% to 4.51%) for SLE patients, 1.94% (95% CI: 1.68% to 2.24%) for control subjects; atrial fibrillation, 4.35% (95% CI: 3.61% to 5.18%) for SLE patients, 2.82% (95% CI: 2.50% to 3.16%) for control subjects; ischemic stroke, 3.75% (95% CI: 3.06% to 4.54%) for SLE patients, 1.92% (95% CI: 1.66% to 2.20%) for control subjects; myocardial infarction, 2.17% (95% CI: 1.66% to 2.80%) for SLE patients, 1.49% (95% CI: 1.26% to 1.75%) for control subjects; venous thromboembolism, 6.03% (95% CI: 5.17% to 6.98%) for SLE patients, 1.68% (95% CI: 1.44% to 1.95%) for control subjects; and the composite of implantable cardioverter-defibrillator implantation/ventricular arrhythmias/cardiac arrest, 0.89% (95% CI: 0.58% to 1.31%) for SLE patients, 0.30% (95% CI: 0.20% to 0.43%) for control subjects. SLE with subsequent HF was associated with higher mortality compared with HF without SLE (adjusted hazard ratio: 1.50; 95% CI: 1.08 to 2.08). CONCLUSIONS SLE patients had a higher associated risk of HF and other cardiovascular outcomes compared with matched control subjects. Among patients developing HF, a history of SLE was associated with higher mortality.
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Yafasova et al. (2021) conducted a cohort in Systemic lupus erythematosus (n=17,055). Systemic lupus erythematosus vs. Age-, sex-, and comorbidity-matched control subjects was evaluated on Heart failure. Systemic lupus erythematosus was associated with a higher 10-year risk of heart failure than controls (3.71% vs 1.94%), and higher mortality following HF diagnosis (HR 1.50; 95% CI 1.08-2.08).
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