RESEARCH - Risk factors for development of coronary artery disease in women with SLE

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J Rheumatol. 2009 Oct 15.

Risk Factors for Development of Coronary Artery Disease in Women with

Systemic Lupus Erythematosus.

Goldberg RJ, Urowitz MB, Ibañez D, Nikpour M, Gladman DD.

From the University of Toronto Lupus Clinic, Centre for Prognosis

Studies in the Rheumatic Diseases, Toronto Western Hospital, Division

of Rheumatology, University of Toronto, Toronto, Ontario, Canada.

OBJECTIVE: To ascertain coronary artery disease (CAD) outcomes and

predictive factors in a prospective study of patients with systemic

lupus erythematosus (SLE) and matched healthy controls.

METHODS: SLE patients and non-SLE age-matched controls without a

history of CAD were recruited into a prospective study between 1997

and 1999. CAD events were assessed at clinic visit for SLE patients

and through telephone interview and chart review for controls. All

events were verified with patient medical records.

RESULTS: Followup information was available on 237 controls and 241

SLE patients. The mean followup time was 7.2 years. Univariate

analyses identified age and postmenopausal status as predictors of CAD

in both the groups. Sedentary lifestyle, hypertension, the presence of

metabolic syndrome, and the number of Framingham risk factors were

predictive in the control group only. The 10-year risk of CAD score

was predictive in both groups but was not as marked in the SLE group

as in the controls. None of the lipid subfractions were predictive for

CAD in the SLE group, whereas in the controls, a high triglyceride

level >/= 2.8 was predictive. Time-to-event multivariate analysis for

CAD in all subjects revealed SLE itself, older age, and triglycerides

>/= 2.8 to be highly predictive for CAD.

CONCLUSION: In a prospective study of patients with SLE and matched

controls followed over a median of 8 years, patients with SLE

developed significantly more CAD events than controls. Accounting for

demographic variability, CAD risk factors, and lipid factors, SLE is

an independent risk factor for the development of CAD.

PMID: 19833754

http://www.ncbi.nlm.nih.gov/pubmed/19833754

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