Cardiovascular Damage in Systemic Lupus Erythematosus Occurs at Early Stages of the Disease. Chronological Analysis of Damage Accrual in a Large Cohort from the Spanish Society of Rheumatology Lupus Registry (RELESSER)

Sara garcia Perez¹, Jose-Maria Pego-Reigosa², Irene Altabás González¹, Norman Jiménez³, Victor Del campo Perez⁴, JULIA MARTINEZ BARRIO⁵, Maria Galindo-Izquierdo⁶, Jaime Calvo- Alén⁷, Esther Uriarte Isacelaya⁸, Eva Tomero Muriel⁹, Mercedes Freire González¹⁰, Victor Martinez-Taboada¹¹, Paloma Vela¹², Antonio Fernandez-Nebro¹³, Alejandro Olivé-Marqués¹⁴, Javier Narvaez¹⁵, Raúl Menor-Almagro¹⁶, Gregorio Santos Soler¹⁷, José Ángel Hernández Beriain¹⁸, Javier Manero ruiz¹⁹, Elena Aurrecoechea Aguinaga²⁰, Oihane Ibarguengoitia-Barrena²¹, Carlos Montilla-Morales²², Gema Bonilla²³, Vicente Torrente-Segarra²⁴, Ana Paula Cacheda²⁵, Maria J. García-Villanueva²⁶, Clara Moriano Morales²⁷, Concepción Fito Manteca²⁸, Cristina Bohórquez²⁹, Nuria Lozano Rivas³⁰ and Iñigo Rúa-Figueroa³¹, ¹Department of Rheumatology, University Hospital of Vigo. IRIDIS Group (Investigation in Rheumatology and Immune-Diseases), Vigo, Spain, ²Rheumatology, Hospital do Meixoeiro, Vigo, Spain, ³IIRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute., Vigo, Spain, ⁴Department of Epidemiology, University Hospital of Vigo, IRIDIS Group (Investigation in Rheumatology and Immune-Diseases), Vigo, Spain, ⁵Rheumatology, Gregorio Marañon University Hospital, Madrid, Spain, ⁶Rheumatology, University Hospital of 12 de Octubre, Madrid, Spain, ⁷Rheumatology, Bioaraba Research Unit, Hospital Universitario Araba, Vitoria, Spain, ⁸Rheumatology, University Hospital of Donosti, San Sebastián, Spain, ⁹Rheumatology, Hospital La Princesa, Madrid, Spain, ¹⁰Rheumatology department, Complexo Hospitalario Universitario A Coruña (CHUAC). Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, Spain, ¹¹Rheumatology, Hospital Marqués de Valdecilla, Santander, Spain, ¹²Department of Rheumatology, University Hospital of Alicante, Alicante, Spain, ¹³Hospital Regional Universitario de Málaga, Malaga, Spain, ¹⁴Department of Rheumatology, Hospital Germans Trias i Pujol, Badalona, Spain, ¹⁵Hospital Universitario de Bellvitge, Barcelona, Spain, ¹⁶Rheumatology, Hospital Jerez, Puerto De Santa María, Spain, ¹⁷Rheumatology, Hospital Marina Baixa Villajoyosa, Alicante, Spain, ¹⁸Rheumatology, Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain, ¹⁹Department of Rheumatology, Hospital Universitario Miguel Servet, Zaragoza, Spain, ²⁰Department of Rheumatology, Hospital Sierrallana, Torrelavega, Spain, ²¹Galdakao-Usansolo University Hospital, Bilbao, Spain, ²²Rheumatology, University Hospital of Salamanca, Salamanca, Spain, ²³Department of Rheumatology, Hospital Clínico Universitario La Paz, Madrid, Spain, ²⁴Department of Rheumatology, Hospital de Sant Joan Despí Moises Broggi,, Sant Joan Despí, Spain, ²⁵Department of Rheumatology, Hospital Son Llatzer, Palma de Mallorca, Spain, ²⁶Hospital Ramón y Cajal, Madrid, Spain, ²⁷Rheumatology, Hospital Universitario de León, León, Spain, ²⁸Department of Rheumatology, University Hospital of Navarra, Pamplona, Spain, ²⁹Department of Rheumatology, University Hospital Príncipe de Asturias, Alcalá de Henares, Spain, ³⁰Department of Rheumatology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, ³¹Rheumatology, Hospital de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain

Meeting: ACR Convergence 2023

Keywords: Cardiovascular, Cohort Study, Damage Index, Systemic lupus erythematosus (SLE)

Session Information

Date: Monday, November 13, 2023

Title: (1442–1487) SLE – Diagnosis, Manifestations, & Outcomes Poster II

Session Type: Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Systemic Lupus Erythematosus (SLE) survival has improved during recent decades, so other outcomes like damage accrual become more relevant. Damage represents that clinical feature that is irreversible and occurs after SLE diagnosis, being present fot at least 6 months. Our approach is to assess damage accrual, with emphasis on the cardiovascular domain over the different stages of the disease in a large SLE cohort.

Methods: Multicentre, cross-sectional study of a cohort of 4,219 SLE patients enrolled in the Spanish Society of Rheumatology Lupus Registry (RELESSER) with an average age at diagnosis (±SD) of 35.9 (±15.1) years, 89,6% of women, 92% caucasian and the average duration (±SD) of SLE 133.2 months. Organ damage was ascertained using the SDI (SLICC/ACR Damage Index). For the chronological analysis we considered, globally and for every SDI domain, only those 1,299 patients whose dates of damage events had been recorded.

Results: After 133 months of follow-up, 2,116 (50.1%) of 4,219 patients manifested some damage. Table 1 shows the comparison between patients with and without damage in the RELESSER Cohort . The damage accrual rate was higher during early stages of the disease, with 22.0% and 38.1% of those patients accumulating damage during the first and third year after SLE diagnosis, respectively. Figure 1 graphically represents the cumulative incidence of global damage over the course of the disease.

Analyzing the different domains, musculoskeletal and neuropsychiatric systems were the ones accumulating more damage at those time points. The musculoskeletal system was the one contributing more to damage during late stages.Including “cerebrovascular accident” and “claudication for 6 months” as cardiovascular items, the cardiovascular system became the second one that contributed the most to damage accrual in the early stages of SLE, with 7.0% and 11,1% of the patients who presented damage doing so in this system at year 1 and 3 after diagnosis, respectively. Figure 2 shows the cumulative incidence of damage (per SDI domain) over the course of the disease from the time of SLE diagnosis.

Conclusion: The higher rate of damage accrual occurs during the first year after SLE diagnosis. The cardiovascular system is the second leading cause of damage accrual within the first years. Strategies to prevent cardiovascular damage should be implemented early on starting from the initial SLE diagnosis.

Table 1. Comparison of patient characteristics with and without damage in the RELESSER-TRANS Cohort

Figure 1.Gobal damage over time

Figure 2. Damage over time by SDI domain

Disclosures: S. garcia Perez: None; J. Pego-Reigosa: None; I. Altabás González: None; N. Jiménez: None; V. Del campo Perez: None; J. MARTINEZ BARRIO: None; M. Galindo-Izquierdo: None; J. Calvo- Alén: AbbVie, 2, AstraZeneca, 2, Biogen, 6, BMS, 5, Galapagos, 6, GSK, 2, 6, Lilly, 2, 6, Novartis, 2, 6, Roche, 5, Sanofi, 2; E. Uriarte Isacelaya: None; E. Tomero Muriel: None; M. Freire González: None; V. Martinez-Taboada: None; P. Vela: None; A. Fernandez-Nebro: None; A. Olivé-Marqués: None; J. Narvaez: None; R. Menor-Almagro: None; G. Santos Soler: None; J. Hernández Beriain: None; J. Manero ruiz: None; E. Aurrecoechea Aguinaga: None; O. Ibarguengoitia-Barrena: None; C. Montilla-Morales: None; G. Bonilla: None; V. Torrente-Segarra: None; A. Cacheda: None; M. García-Villanueva: AstraZeneca, 6, GSK, 6, Otsuka, 1; C. Moriano Morales: None; C. Fito Manteca: None; C. Bohórquez: None; N. Lozano Rivas: None; I. Rúa-Figueroa: AstraZeneca, 5, GSK, 1, 6.

To cite this abstract in AMA style:

garcia Perez S, Pego-Reigosa J, Altabás González I, Jiménez N, Del campo Perez V, MARTINEZ BARRIO J, Galindo-Izquierdo M, Calvo- Alén J, Uriarte Isacelaya E, Tomero Muriel E, Freire González M, Martinez-Taboada V, Vela P, Fernandez-Nebro A, Olivé-Marqués A, Narvaez J, Menor-Almagro R, Santos Soler G, Hernández Beriain J, Manero ruiz J, Aurrecoechea Aguinaga E, Ibarguengoitia-Barrena O, Montilla-Morales C, Bonilla G, Torrente-Segarra V, Cacheda A, García-Villanueva M, Moriano Morales C, Fito Manteca C, Bohórquez C, Lozano Rivas N, Rúa-Figueroa I. Cardiovascular Damage in Systemic Lupus Erythematosus Occurs at Early Stages of the Disease. Chronological Analysis of Damage Accrual in a Large Cohort from the Spanish Society of Rheumatology Lupus Registry (RELESSER) [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/cardiovascular-damage-in-systemic-lupus-erythematosus-occurs-at-early-stages-of-the-disease-chronological-analysis-of-damage-accrual-in-a-large-cohort-from-the-spanish-society-of-rheumatology-lupus-r/. Accessed .

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