RESEARCH - SLE and the risk of cardiovascular disease

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Arthritis Rheum. 2009 Sep 29;61(10):1396-1402.

Systemic lupus erythematosus and the risk of cardiovascular disease:

Results from the nurses' health study.

Hak AE, Karlson EW, Feskanich D, Stampfer MJ, Costenbader KH.

Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

OBJECTIVE: Systemic lupus erythematosus (SLE) has been associated with

an increased risk of cardiovascular disease. However, prospective

population-based data addressing this association have been lacking.

METHODS: We conducted a prospective cohort study among 119,332 women

participating in the Nurses' Health Study who were free of

cardiovascular disease and SLE at baseline in 1976. Incident SLE was

confirmed by medical record review. Cardiovascular events included

fatal and nonfatal myocardial infarction, stroke, coronary artery

bypass grafting, and angioplasty. The relative risk (RR) of

cardiovascular events among participants with SLE as compared with

those without SLE was estimated using proportional hazards models.

RESULTS: Over 28 years of followup (2.9 million person-years), 8,169

cardiovascular events occurred and 148 women developed incident SLE.

The mean age at SLE diagnosis was 52.6 years, and 20 participants with

SLE developed a subsequent cardiovascular event. After adjusting for

potential confounding factors, including age, race, cardiovascular

risk factors, and medication use, the RR of a cardiovascular event in

women with SLE compared with those without SLE was 2.26 (95%

confidence interval [95% CI] 1.45-3.52). When end points were analyzed

separately, the RR for coronary heart disease was 2.25 (95% CI

1.37-3.69) and the RR for stroke was 2.29 (95% CI 0.85-6.15).

CONCLUSION: In this prospective population-based study, we found a

statistically significant >2-fold increased risk of cardiovascular

disease among participants with SLE. The risk was not as high as has

been previously reported, which may have been due to the relatively

high age at diagnosis of SLE in this cohort.

PMID: 19790130

http://www.ncbi.nlm.nih.gov/pubmed/19790130

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