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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Accrual of Atherosclerotic Vascular Events in a Multicenter Inception Systemic Lupus Erythematosus Cohort
Arthritis & rheumatology (Hoboken, N.J.), v 72(10), pp 1734-1740
Oct 2020
PMID: 32515554
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective
In previous studies, atherosclerotic vascular events (AVEs) were shown to occur in ~10% of patients with systemic lupus erythematosus (SLE). We undertook this study to investigate the annual occurrence and potential risk factors for AVEs in a multinational, multiethnic inception cohort of patients with SLE.
Methods
A large 33‐center cohort of SLE patients was followed up yearly between 1999 and 2017. AVEs were attributed to atherosclerosis based on SLE being inactive at the time of the AVE as well as typical atherosclerotic changes observed on imaging or pathology reports and/or evidence of atherosclerosis elsewhere. Analyses included descriptive statistics, rate of AVEs per 1,000 patient‐years, and univariable and multivariable relative risk regression models.
Results
Of the 1,848 patients enrolled in the cohort, 1,710 had ≥1 follow‐up visit after enrollment, for a total of 13,666 patient‐years. Of these 1,710 patients, 3.6% had ≥1 AVEs attributed to atherosclerosis, for an event rate of 4.6 per 1,000 patient‐years. In multivariable analyses, lower AVE rates were associated with antimalarial treatment (hazard ratio [HR] 0.54 [95% confidence interval (95% CI) 0.32–0.91]), while higher AVE rates were associated with any prior vascular event (HR 4.00 [95% CI 1.55–10.30]) and a body mass index of >40 kg/m
2
(HR 2.74 [95% CI 1.04–7.18]). A prior AVE increased the risk of subsequent AVEs (HR 5.42 [95% CI 3.17–9.27],
P
< 0.001).
Conclusion
The prevalence of AVEs and the rate of AVE accrual demonstrated in the present study is much lower than that seen in previously published data. This may be related to better control of both the disease activity and classic risk factors.
Metrics
Details
- Title
- Accrual of Atherosclerotic Vascular Events in a Multicenter Inception Systemic Lupus Erythematosus Cohort
- Creators
- Murray B. Urowitz - Toronto Western HospitalDafna D. Gladman - Toronto Western HospitalVernon Farewell - University of CambridgeJiandong Su - Toronto Western HospitalJuanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránSang-Cheol Bae - Hanyang University Seoul HospitalPaul R. Fortin - Centre hospitalier de l'Université LavalJorge Sanchez-Guerrero - Toronto Western HospitalAnn Elaine Clarke - University of CalgarySasha Bernatsky - McGill University Health CentreCaroline Gordon - University of BirminghamJohn G. Hanly - Queen Elizabeth II Health Sciences CentreDaniel J. Wallace - Cedars-Sinai Medical CenterDavid A. Isenberg - University College LondonAnisur Rahman - University College LondonJoan T. Merrill - Oklahoma Medical Research FoundationEllen Ginzler - SUNY Downstate Health Sciences UniversityGraciela S. Alarcón - University of Alabama at BirminghamW. Winn Chatham - University of Alabama at BirminghamMichelle A. Petri - Johns Hopkins UniversityIan N. Bruce - NIHR Manchester Biomedical Research CentreMunther A. Khamashta - St Thomas' HospitalCynthia Aranow - Feinstein Institute for Medical ResearchMary Anne Dooley - University of North Carolina at Chapel HillSusan Manzi - Allegheny Health NetworkRosalind Ramsey-Goldman - Northwestern UniversityOla Nived - Lund UniversityAndreas Jönsen - Lund UniversityKristján Steinsson - Reykjavík UniversityAsad A. Zoma - Hairmyres HospitalGuillermo Ruiz-Irastorza - Hospital de CrucesS. Sam Lim - Emory UniversityKenneth C. Kalunian - University of California, San DiegoMurat Ỉnanç - Istanbul UniversityRonald van Vollenhoven - Amsterdam University Medical CentersManuel Ramos-Casals - Consorci Institut D'Investigacions Biomediques August Pi I SunyerDiane L. Kamen - Medical University of South CarolinaSoren Jacobsen - Copenhagen University HospitalChristine A. Peschken - University of ManitobaAnca Askanase - New York University Langone Orthopedic HospitalThomas Stoll - Spitäler Schaffhausen
- Publication Details
- Arthritis & rheumatology (Hoboken, N.J.), v 72(10), pp 1734-1740
- Publisher
- Wiley
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000562176700001
- Scopus ID
- 2-s2.0-85089782157
- Other Identifier
- 991021933907904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology