Mortality and cardiovascular burden of systemic lupus erythematosus in a US population-based cohort.
Mortality and cardiovascular burden of systemic lupus erythematosus in a US population-based cohort.
复制标题
DOI：
10.3899/jrheum.130874
复制
发表时间：
2014-04
期刊：
影响因子：
--
通讯作者：
Greenlee RT
中科院分区：
文献类型：
--
作者：
Bartels CM;Buhr KA;Goldberg JW;Bell CL;Visekruna M;Nekkanti S;Greenlee RT
研究以人群为基础的系统性红斑狼疮（SLE）患者的死亡率和心血管疾病（CVD）负担，这些患者的平均发病时间较晚，器官威胁疾病的发生率较低。这项基于人群的回顾性队列研究调查了1991-2008年诊断的SLE病例，并随访至2009年3月，以检查死亡率和心血管事件：心肌梗死、中风或充血性心力衰竭住院治疗。病例的确定采用了1982年美国风湿病学会SLE标准的1997年更新版。搜索包括电子记录、图表审计和州死亡匹配，并附有医生审查。年龄和性别匹配的人群比较有助于相对事件发生率的计算。70例SLE发病较晚（52岁），发病率为5例/ 10万/年。配对比较显示高血压、高脂血症和糖尿病的基线率相似。然而，SLE患者在SLE诊断前2年经历了更多的心血管疾病，优势比为3.8 （95% CI 1.8, 8.0）。SLE患者的10年死亡率估计为26%，对照组为19%，风险比（HR） 2.1, p<0.01。调整既往CVD后，SLE患者的死亡率（HR 1.9, p=0.01）和CVD事件或死亡（HR 1.8, p=0.01）的风险仍然增加。与年龄和性别匹配的比较相比，该事件SLE队列显示出大约两倍的死亡率和CVD事件风险，即使考虑到SLE诊断前2年较高的CVD事件。这提出了关于延迟狼疮诊断与SLE前加速CVD的未来研究问题，特别是在年龄较大的SLE中。
To examine the mortality and cardiovascular disease (CVD) burden among a population-based cohort of patients with systemic lupus erythematosus (SLE) with previously described late mean onset and low rates of organ-threatening disease. This retrospective population-based cohort study investigated incident cases of SLE diagnosed from 1991–2008 and followed through March 2009 to examine rates of death and CVD events: myocardial infarction, stroke, or congestive heart failure hospitalization. Cases were identified using the 1997 update of 1982 American College of Rheumatology SLE criteria. Searches included electronic records, chart audits, and state death matches, with physician review. Age and sex-matched population comparisons facilitated relative event rate calculations. 70 incident SLE cases had late mean onset (52 years), with an incidence of 5 cases per 100,000/year. Matched comparisons showed similar baseline rates of hypertension, hyperlipidemia, and diabetes. However, SLE patients experienced more CVD in the 2 years preceding SLE diagnosis, odds ratio 3.8 (95% CI 1.8, 8.0). The estimated 10-year mortality rates were 26% for SLE subjects versus 19% for comparisons, hazard ratio (HR) 2.1, p<0.01. Adjusted for prior CVD, SLE cases still demonstrated increased hazards of mortality (HR 1.9, p=0.01) and CVD event or death (HR 1.8, p=0.01). This incident SLE cohort demonstrated approximately doubled mortality and CVD event hazards compared to age and sex-matched comparisons, even after accounting for higher CVD events in the 2 years preceding SLE diagnosis. This raises future research questions regarding delayed lupus diagnosis versus accelerated CVD prior to SLE, particularly in older-onset SLE.
登录
查看更多内容
影响因子：
5
作者：
Magder, Laurence S.;Petri, Michelle
通讯作者：
Petri, Michelle
影响因子：
3
作者：
Larson, SL;Fleishman, JA
通讯作者：
Fleishman, JA
影响因子：
1.4
作者：
Borzecki, AM;Wong, AT;Berlowitz, DR
通讯作者：
Berlowitz, DR
影响因子：
4.7
作者：
Lim, S. Sam;Drenkard, Cristina;Somers, Emily C.
通讯作者：
Somers, Emily C.
影响因子：
3.9
作者：
Lalani, Sheliza;Pope, Janet;Peschken, Christine
通讯作者：
Peschken, Christine