Background Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune condition with multi-organ involvement. Although atherosclerotic vascular involvement is not the most common, in time this is related to increasing mortality.
Objectives To characterize a SLE cohort from the cardiovascular events perspective, in order to improve our prevention strategies.
Methods We enroled 65 patients with SLE admitted in SF Maria Hospital in 2014. All patients gave informed consent for all procedures. We performed a complete evaluation of all patients both clinical and paraclinical, including disease activity score – SELENA-SLEDAI, damage score – SLICC damage index (SDI), history of the disease and medication, association with atherosclerotic cardiovascular disease. The statistic analysis was made with SPSS 20.0.
Results Almost half of the patients – 49% had at least one cardiovascular events, most of them being younger then 50 years. Ischemic events found in our cohort were: ischemic heart disease like acute myocardial infarction or angina pectoris, aortic abdominal aneurism, peripheral ischemic arterial disease and ischmic cerebrovascular disease. Established atherosclerotic risk factors with significant correlation (p<0.05) in this group of patients were: high blood pressure (p 0.011), menopause (p 0.0001), heredo-collateral vascular disease (p 0.029), high Body Mass Index (p 0.035), sedentary life style (p 0.035). We also found predictive factors that are related to the SLE itself: 83.33% from sub-group of patients with atherosclerotic cardiovascular involvement had positive antiphospholipidic Ab (p<0.001), 87,5% from this patients had a disease longer then 5 years (p 0,010) and 66% had a SDI greater or equal to one (p 0.035). Older age at SLE diagnosis was significant associated with vascular involvement (p 0.001).
Conclusions Routine assessment for this vascular pathology should be implemented in evaluation of SLE patients. Presence of correctable risk factors like hypertension, obesity or sedentary life style must be checked regularly. Special attention for prompt identification of this co-morbiditie is especially important in long standing disease that already accumulated damage.
Knight JS, Kaplan MJ. Cardiovascular disease in lupus: insights and updates. Curr Opin Rheumatol. 2013;25(5):597-605.
Disclosure of Interest None declared