Session Information
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose:
Cardiovascular disease (CVD) is a common cause of morbidity and mortality in systemic lupus erythematosus (SLE). We know that a combination of traditional cardiovascular disease (CVD) risk factors and dysregulation of the immune system play a role in the pathogenesis. Strict adherence to established preventive measures in these patients is important. This study evaluated secondary prevention of CVD in a large population-based SLE cohort.
Methods:
Georgians Organized Against Lupus (GOAL) is a population-based cohort of patients with validated SLE surveyed annually and matched to the Georgia Hospital Discharge Database to capture all hospitalizations throughout the state. Those with CVD were identified from responses to the validated Self-Administered Brief Index of Lupus Damage. CVD related hospitalizations were identified based on the first 3 admission codes.
Results:
164 out of 685 respondents had CVD. Patients with CVD were more often older, black, poor, unemployed and on Medicare/Medicaid. Blood pressure was monitored very well. Most but not all received an annual check-up and cholesterol monitoring. Measures that were met the least included not smoking, adequate physical activity and aspirin adherence. Smokers were more often on Medicare/Medicaid than non-smokers (p=0.015).
Conclusion:
SLE patients with known CVD are at high risk for recurrent cardiovascular events and mortality, making prevention a crucial and cost effective priority. There continues to be significant room for improvement in many preventive measures. Further study may direct education and resources to improve performance in these areas.
Table 1: Socio-demographic description of the GOAL Cohort
|
Descriptors |
GOAL Cohort (N=685) |
CVD status |
||
|
Non-CVD (n=519) |
CVD (N=164) |
P Value |
||
|
Age ( mean ± SD)
|
48.1 ± 13.2 |
46.5 ± 12.7 |
53.1 ± 13.3 |
<0.0001 |
|
Gender |
||||
|
Male
|
40 (5.8) |
26 (5.0) |
14 (8.5) |
0.094 |
|
Female
|
645 (94.2) |
493 (95.0) |
150 (91.5) |
|
|
Race |
||||
|
Black
|
529 (77.2) |
392 (75.5) |
135 (82.3) |
0.17 |
|
White
|
144 (21.0) |
118 (22.7) |
26 (15.9) |
|
|
Living below poverty level |
256 (37.3) |
183 (35.2) |
72 (44.0) |
0.019 |
|
Unemployed or disabled |
356 (52.0) |
231 (44.5) |
124 (75.6) |
<0.0001 |
|
Insurance |
|
|
|
|
|
Private
|
291 (42.5) |
239 (46.1) |
52 (31.7) |
0.0012 |
|
Medicaid
|
182 (26.6) |
116 (22.4) |
66 (40.2) |
<0.0001 |
|
Medicare
|
245 (35.8) |
150 (28.9) |
95 (57.9) |
<0.0001 |
|
Underinsured/uninsured
|
125(18.2) |
99 (19.1) |
25 (15.2) |
0.27 |
Table 2: Meeting secondary and other preventive measures in the GOAL Cohort with known CVD within the past year
|
GOAL Cohort with CVD(N=164) |
||
|
Met N (%) |
Did Not Meet N (%) |
|
|
Blood pressure monitoring |
157 (96.9) |
5 (3.1) |
|
Annual check up |
132 (84.6) |
24 (15.4) |
|
Cholesterol monitoring |
130 (80.2) |
32 (19.7) |
|
Not smoking |
107 (69.0) |
48 (31.0) |
|
Flu vaccination |
103 (63.6) |
59 (36.4) |
|
Aspirin adherence |
96 (60.4) |
63 (39.6) |
|
Cardiology visit |
84 (58.3)
|
60 (41.7) |
|
Adequate physical activity |
90 (56.3) |
70 (43.7) |
|
· Physical activity : any exercise within the past month other than regular job |
||
To cite this abstract in AMA style:
John S, Drenkard C, Bao G, Lim SS. Secondary Prevention of Cardiovascular Disease Is Incomplete in a Systemic Lupus Erythematosus Population-Based Cohort [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/secondary-prevention-of-cardiovascular-disease-is-incomplete-in-a-systemic-lupus-erythematosus-population-based-cohort/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/secondary-prevention-of-cardiovascular-disease-is-incomplete-in-a-systemic-lupus-erythematosus-population-based-cohort/