ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 648

Atherosclerotic Vascular Events in a Multinational Inception Cohort of Systemic Lupus Erythematosus: Incidence Over a Ten Year Period

D. D. Gladman1, Dominique Ibanez2, Murray B. Urowitz2 and SLICC3, 1Division of Rheumatology, Toronto Western Hospital and University of Toronto, Toronto, ON, Canada, 2Division of Rheumatology, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 3Division of Rheumatology Toronto Western Hospital, Toronto, ON, Canada

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Systemic Lupus Erythematosus: Clinical Aspects

Session Type: Abstract Submissions (ACR)

Background/Purpose: A large multicentre multinational inception cohort was established to study risk factors for atherosclerosis (AS) in SLE. The purpose of this study was to determine the incidence of vascular events during a 10 year follow-up and their attribution to AS.
Methods: An inception cohort of SLE patients from 31 centres from 12 countries has been assembled according to a standardized protocol between 2000 and 2012 to study risk factors for atherosclerosis. Patients enter the cohort within 15 months of SLE diagnosis (≥4 ACR criteria). Clinical and laboratory features of SLE and comorbidities are gathered in a standardized protocol at yearly intervals. Vascular events (VE) are described and attributed to SLE and AS on a specialized form. Events recorded include myocardial infarction (MI), angina, congestive heart failure (CHF), intermittent claudication (PVD), stroke, transient ischemic attack (TIA). Diagnosis of an event was confirmed using standard clinical criteria, relevant laboratory data and imaging where appropriate. Attribution to AS was made on the basis of lupus disease being inactive at the time of the event, and/or the presence of typical AS changes on imaging or pathology and/or evidence of AS elsewhere. The incidence of VE was calculated over the 10 years for all VE occurring after diagnosis, and then for atherosclerotic VE  (AVE). Kaplan-Meier curves were used  to estimate the cumulative incidence rates since SLE diagnosis

Results: Since 2000 1844 patients have been entered into the cohort (88.9%F, age at SLE 34.7y). Caucasian 49.2%, Black 16.5%, Asian 14.9%, Hispanic 15.3%, other 4.1%.  Thus far there have been 157 VE in 115 patients after the diagnosis of SLE. These include: MI (14), angina (26), CHF (36), PVD (11), TIA (27), stroke (38), pacemaker insertion (5). 64 of the events were attributed to active lupus and 44 to other causes or missing. 49 events in 37 patients were attributed to AS including: MI (8), angina (19), CHF (6), PVD (6), TIA (5), pacemaker (3), stroke (2).

Table cumulative incidence of 1st vascular events since diagnosis of SLE

Years since SLE Dx

Number

VE

N=115

AVE

N=37

0

1844

0.2%

0.1%

1

1479

3.0%

0.7%

2

1305

4.0%

0.9%

3

1097

5.4%

1.4%

4

948

6.2%

1.9%

5

768

7.3%

2.4%

6

600

7.7%

2.5%

7

459

8.9%

2.9%

8

342

9.4%

3.2%

9

233

10.1%

3.9%

10

138

11.2%

4.4%

 

Conclusion : Over the follow-up of an inception cohort with SLE there were 157 vascular events of which 49 were attributable to AS.  The incidence of AVE increased by 0.5% per year reaching a total of 4.4% at 10 years.

Disclosure:

D. D. Gladman,
None;

D. Ibanez,
None;

M. B. Urowitz,
None;

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/atherosclerotic-vascular-events-in-a-multinational-inception-cohort-of-systemic-lupus-erythematosus-incidence-over-a-ten-year-period/