Patients with SLE have higher risk of cardiovascular events and mortality in comparison with controls with the same levels of traditional risk factors and intima-media measures, which is related to accumulated disease damage and antiphospholipid syndrome: a case-control study over 10 years.
Patients with SLE have higher risk of cardiovascular events and mortality in comparison with controls with the same levels of traditional risk factors and intima-media measures, which is related to accumulated disease damage and antiphospholipid syndrome: a case-control study over 10 years.
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与具有相同水平的传统危险因素和内膜中层措施的对照组相比，SLE患者发生心血管事件和死亡率的风险更高，这与累积的疾病损害和抗磷脂综合征有关：一项为期10年的病例对照研究。
DOI：
10.1136/lupus-2020-000454
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发表时间：
2021-03
影响因子：
3.9
通讯作者：
Frostegård J
中科院分区：
文献类型：
--
作者：
Ajeganova S;Hafström I;Frostegård J
SLE是早发心血管（CV）疾病和死亡率的一个重要危险因素。我们研究了与对照组相比，哪些因素可以解释SLE预后不良。本研究招募了进行颈动脉超声检查的SLE患者和无临床CV事件史的人群对照。结局为CV事件和死亡。使用Kaplan-Meier曲线比较无事件生存率。使用相对HR（95% CI）估计结局风险。患者（n=99，87%为女性），年龄47（13）岁，疾病持续时间12（9）年，入选时患有轻度疾病，系统性红斑狼疮疾病活动指数评分为3（1-6），系统性红斑狼疮国际合作诊所（SLICC）损伤指数评分为0（0-1）。对照组（n=109，91%为女性）年龄为49（12）岁。基线颈动脉内膜中层厚度（cIMT）在两组之间没有差异，但斑块在患者中更普遍（p=0.068）。在10.1（9.8-10.2）年期间，12例患者和4例对照达到结局（p=0.022）。与对照组相比，考虑到年龄、性别、吸烟和糖尿病史、CV家族史、基线体重指数、腰围、C反应蛋白、总胆固醇、高密度脂蛋白、低密度脂蛋白、血脂异常、cIMT和颈动脉斑块的存在，患者不良结局的风险增加了3倍至4倍。在患者中，较高的SLICC评分和SLE-抗磷脂综合征（SLE-APS）与不良结局风险增加相关，HR分别为1.66（95% CI 1.20 - 2.28）和9.08（95% CI 2.71 - 30.5），cIMT也是如此，HR为1.006（95% CI 1.002 - 1.01）。SLICC和SLE-APS与cIMT的组合显著改善了不良结局的预测（p<0.001）。在病程超过10年的轻度SLE患者中，CV事件和死亡的风险是未患SLE的患者的3 - 4倍，其传统CV风险因素、cIMT和颈动脉斑块的存在模式相似。SLICC、SLE-APS和亚临床动脉粥样硬化可能提示SLE预后不良的风险组。
SLE is a strong risk factor for premature cardiovascular (CV) disease and mortality. We investigated which factors could explain poor prognosis in SLE compared with controls. Patients with SLE and population controls without history of clinical CV events who performed carotid ultrasound examination were recruited for this study. The outcome was incident CV event and death. Event-free survival rates were compared using Kaplan-Meier curves. Relative HR (95% CI) was used to estimate risk of outcome. Patients (n=99, 87% female), aged 47 (13) years and with a disease duration of 12 (9) years, had mild disease at inclusion, Systemic Lupus Erythematosus Diseases Activity Index score of 3 (1–6) and Systemic Lupus International Collaborating Clinics (SLICC) Damage Index score of 0 (0–1). The controls (n=109, 91% female) were 49 (12) years old. Baseline carotid intima-media thickness (cIMT) did not differ between the groups, but plaques were more prevalent in patients (p=0.068). During 10.1 (9.8-10.2) years, 12 patients and 4 controls reached the outcome (p=0.022). Compared with the controls, the risk of the adverse outcome in patients increased threefold to fourfold taking into account age, gender, history of smoking and diabetes, family history of CV, baseline body mass index, waist circumference, C reactive protein, total cholesterol, high-density lipoprotein, low-density lipoprotein, dyslipidaemia, cIMT and presence of carotid plaque. In patients, higher SLICC score and SLE-antiphospholipid syndrome (SLE-APS) were associated with increased risk of the adverse outcome, with respective HRs of 1.66 (95% CI 1.20 to 2.28) and 9.08 (95% CI 2.71 to 30.5), as was cIMT with an HR of 1.006 (95% CI 1.002 to 1.01). The combination of SLICC and SLE-APS with cIMT significantly improved prediction of the adverse outcome (p<0.001). In patients with mild SLE of more than 10 years duration, there is a threefold to fourfold increased risk of CV events and death compared with persons who do not have SLE with similar pattern of traditional CV risk factors, cIMT and presence of carotid plaque. SLICC, SLE-APS and subclinical atherosclerosis may indicate a group at risk of worse outcome in SLE.
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影响因子：
1.6
作者：
Bundhun PK;Boodhoo KD;Long MY;Chen MH
通讯作者：
Chen MH
影响因子：
5.5
作者：
Kravvariti, Evrydiki;Konstantonis, George;Tektonidou, Maria G.
通讯作者：
Tektonidou, Maria G.
影响因子：
3.9
作者：
Chen, Hung-Lin;Shen, Li-Jiuan;Hsiao, Fei-Yuan
通讯作者：
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影响因子：
5
作者：
Magder, Laurence S.;Petri, Michelle
通讯作者：
Petri, Michelle
影响因子：
39.2
作者：
JESSAR, RA;LAMONTHAVERS, RW;RAGAN, C
通讯作者：
RAGAN, C