Cardiovascular Events in Systemic Lupus Erythematosus

This article estimates the frequency of cardiovascular (CV) events that occurred after diagnosis in a large Spanish cohort of patients with systemic lupus erythematosus (SLE) and investigates the main risk factors for atherosclerosis. RELESSER is a nationwide multicenter, hospital-based registry of SLE patients. This is a cross-sectional study. Demographic and clinical variables, the presence of traditional risk factors, and CV events were collected. A CV event was defined as a myocardial infarction, angina, stroke, and/or peripheral artery disease. Multiple logistic regression analysis was performed to investigate the possible risk factors for atherosclerosis. From 2011 to 2012, 3658 SLE patients were enrolled. Of these, 374 (10.9%) patients suffered at least a CV event. In 269 (7.4%) patients, the CV events occurred after SLE diagnosis (86.2% women, median interquartile range age 54.9 years 43.2-66.1, and SLE duration of 212.0 months 120.8-289.0). Strokes (5.7%) were the most frequent CV event, followed by ischemic heart disease (3.8%) and peripheral artery disease (2.2%). Multivariate analysis identified age (odds ratio 95% confidence interval, 1.03 1.02-1.04), hypertension (1.71 1.20-2.44), smoking (1.48 1.06-2.07), diabetes (2.2 1.32-3.74), dyslipidemia (2.18 1.54-3.09), neurolupus (2.42 1.56-3.75), valvulopathy (2.44 1.34-4.26), serositis (1.54 1.09-2.18), antiphospholipid antibodies (1.57 1.13-2.17), low complement (1.81 1.12-2.93), and azathioprine (1.47 1.04-2.07) as risk factors for CV events. We have confirmed that SLE patients suffer a high prevalence of premature CV disease. Both traditional and nontraditional risk factors contribute to this higher prevalence. Although it needs to be verified with future studies, our study also shows-for the first time-an association between diabetes and CV events in SLE patients.