Long-Term Cardiovascular Outcomes in Systemic Lupus Erythematosus
| Autor: | Emil L. Fosbøl, Guoli Sun, Adelina Yafasova, Pardeep S. Jhund, Mikkel Faurschou, Jawad H. Butt, John J.V. McMurray, Lars Køber, Morten Schou, Kieran F. Docherty, Christian Torp-Pedersen, Søren Lund Kristensen, Bo Baslund |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Percentile Denmark Population Long Term Adverse Effects 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Outcome Assessment Health Care medicine Humans Lupus Erythematosus Systemic Registries 030212 general & internal medicine Myocardial infarction Mortality skin and connective tissue diseases education Heart Failure education.field_of_study business.industry Hazard ratio Atrial fibrillation medicine.disease Confidence interval Defibrillators Implantable Heart Arrest Cardiovascular Diseases Heart Disease Risk Factors Heart failure Female Cardiology and Cardiovascular Medicine business Cardiovascular outcomes |
| Zdroj: | Journal of the American College of Cardiology. 77:1717-1727 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2021.02.029 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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