Journal article
Cardiovascular events prior to or early after diagnosis of systemic lupus erythematosus in the systemic lupus international collaborating clinics cohort
Lupus science & medicine, v 3(1), e000143
01 Jan 2016
PMID: 27099765
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
ObjectiveTo describe the frequency of myocardial infarction (MI) prior to the diagnosis of systemic lupus erythematosus (SLE) and within the first 2 years of follow-up.MethodsThe systemic lupus international collaborating clinics (SLICC) atherosclerosis inception cohort enters patients within 15 months of SLE diagnosis. MIs were reported and attributed on a specialised vascular event form. MIs were confirmed by one or more of the following: abnormal ECG, typical or atypical symptoms with ECG abnormalities and elevated enzymes (≥2 times upper limit of normal), or abnormal stress test, echocardiogram, nuclear scan or angiogram. Descriptive statistics were used.Results31 of 1848 patients who entered the cohort had an MI. Of those, 23 patients had an MI prior to SLE diagnosis or within the first 2 years of disease. Of the 23 patients studied, 60.9% were female, 78.3% were Caucasian, 8.7% black, 8.7% Hispanic and 4.3% other. The mean age at SLE diagnosis was 52.5±15.0 years. Of the 23 MIs that occurred, 16 MIs occurred at a mean of 6.1±7.0 years prior to diagnosis and 7 occurred within the first 2 years of follow-up. Risk factors associated with early MI in univariate analysis are male sex, Caucasian, older age at diagnosis, hypertension, hypercholesterolaemia, family history of MI and smoking. In multivariate analysis only age (OR=1.06 95% CI 1.03 to 1.09), hypertension (OR=5.01, 95% CI 1.38 to 18.23), hypercholesterolaemia (OR=4.43, 95% CI 1.51 to 12.99) and smoking (OR=7.50, 95% CI 2.38 to 23.57) remained significant risk factors.ConclusionsIn some patients with lupus, MI may develop even before the diagnosis of SLE or shortly thereafter, suggesting that there may be a link between autoimmune inflammation and atherosclerosis.
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Details
- Title
- Cardiovascular events prior to or early after diagnosis of systemic lupus erythematosus in the systemic lupus international collaborating clinics cohort
- Creators
- M B Urowitz - University of TorontoD D Gladman - Toronto Western HospitalN M Anderson - Toronto Western HospitalJ Su - Toronto Western HospitalJ Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránS C Bae - Hanyang University Seoul HospitalP R Fortin - Centre hospitalier universitaire de QuébecJ Sanchez-Guerrero - Toronto Western HospitalA Clarke - University of CalgaryS Bernatsky - McGill University Health CentreC Gordon - University of BirminghamJ G Hanly - Dalhousie UniversityD J Wallace - Cedars-Sinai Medical CenterD Isenberg - University College LondonA Rahman - University College LondonJ Merrill - Oklahoma Medical Research FoundationE Ginzler - SUNY Downstate Health Sciences UniversityG S Alarcón - University of Alabama at BirminghamB F Fessler - University of Alabama at BirminghamM Petri - Johns Hopkins MedicineI N Bruce - Manchester Academic Health Science CentreM Khamashta - King's College LondonC Aranow - Feinstein Institute for Medical ResearchM Dooley - University of North Carolina at Chapel HillS Manzi - Department of Medicine, West Penn Allegheny, Pittsburgh, Pennsylvania, USAR Ramsey-Goldman - Northwestern UniversityG Sturfelt - Lund UniversityO Nived - Lund UniversityK Steinsson - National University Hospital of IcelandA Zoma - Hairmyres HospitalG Ruiz-Irastorza - University of the Basque CountryS Lim - Emory UniversityK C Kalunian - University of California, San DiegoM Ỉnanç - Istanbul UniversityR van Vollenhoven - Karolinska InstitutetM Ramos-Casals - Consorci Institut D'Investigacions Biomediques August Pi I SunyerD L Kamen - Medical University of South CarolinaS Jacobsen - RigshospitaletC Peschken - University of ManitobaA Askanase - Columbia University Irving Medical CenterT Stoll - Spitäler Schaffhausen
- Publication Details
- Lupus science & medicine, v 3(1), e000143
- Publisher
- British Medical Journal (BMJ)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000447605800013
- Scopus ID
- 2-s2.0-85059684243
- Other Identifier
- 991021933906004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology