RESEARCH - Predictors of cardiovascular damage in patients with SLE: LUMINA (LXVIII)

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Rheumatology Advance Access originally published online on May 19, 2009

Rheumatology 2009 48(7):817-822; doi:10.1093/rheumatology/kep102

Predictors of cardiovascular damage in patients with systemic lupus

erythematosus: data from LUMINA (LXVIII), a multiethnic US cohort

Guillermo J. Pons-Estel1, A. González1, Jie Zhang1, a I.

Burgos1, D. Reveille2, M. Vilá3 and Graciela S. Alarcón1,4

1Department of Medicine, Division of Clinical Immunology and

Rheumatology, Schools of Medicine and Public Health, The University of

Alabama at Birmingham, Birmingham, AL,2Department of Medicine,

Division of Rheumatology, The University of Texas Health Science

Center at Houston, Houston, TX, USA,3Department of Medicine, Division

of Rheumatology, The University of Puerto Rico Medical Sciences

Campus, San , Puerto Rico, Spain and 4Department of Epidemiology,

Schools of Medicine and Public Health, The University of Alabama at

Birmingham, Birmingham, AL, USA.

Abstract

Objective. To determine the features predictive of atherosclerotic

cardiovascular damage in patients with SLE.

Methods. SLE LUMINA (LUpus in MInorities: NAture vs nurture) patients

(n = 637), aged 16 years, disease duration 5 years at baseline (T0),

of African–American, Hispanic and Caucasian ethnicity were studied.

Atherosclerotic cardiovascular damage was defined by the following

items of the SLICC Damage Index (SDI) cardiovascular domain: angina or

coronary artery by pass surgery, myocardial infarction and/or

congestive heart failure; factors associated with its occurrence were

examined by univariable and multivariable regression analyses.

Results. Forty-three (6.8%) of 637 patients developed cardiovascular

damage over a mean ± S.D. total disease duration of 6.6 ± 3.6 years.

Nearly 90% of the patients were women with a mean ± S.D. age of 36.5

(12.6) years; all ethnic groups were represented. By multivariable

analyses, after adjusting for the cardiovascular manifestations

present, age [odds ratio (OR) = 1.06; 95% CI 1.03, 1.09], male gender

(OR = 3.57; 95% CI 1.35, 9.09) SDI at baseline (OR = 1.28; 95% CI

1.09, 1.50) and CRP levels [highest tertile (OR = 2.63; 95% CI 1.17,

5.91)] were associated with the occurrence of cardiovascular damage,

whereas the number of years of education was negatively associated

with such outcome (OR = 0.85; 95% CI 0.74, 0.94).

Conclusions. Our data suggest that atherosclerotic cardiovascular

damage in SLE is multifactorial; traditional (age, gender) and

disease-related factors (CRP levels, SDI at baseline) appear to be

important contributors to such an occurrence. Tight control of the

inflammatory process must be achieved to prevent it.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/48/7/817?etoc

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