Background/Purpose: To evaluate the incidence and variability of traditional coronary artery disease (CAD) risk factors in a cohort of systemic lupus erythematosus (SLE) patients.

Methods: 174 women were included (T0) in this prospective study on SLE atherosclerosis. The following traditional CAD risk factors were analyzed: hypertension (blood pressure ≥140/90 mmHg or antihypertensive medication), diabetes mellitus (DM) (fasting glucose ≥ 126mg/dl on at least two occasions or use of oral hypoglycemic agents or insulin), dyslipidemia (total-cholesterol ≥200mg/dl or HDL <40mg/dl or LDL ≥130mg/dl or use of oral lipid-lowering agents), hypertriglyceridemia (triglycerides ≥150mg/dl), obesity (body mass index ≥30kg/m²), abdominal obesity (waist circumference ≥88cm), smoking, positive family history for coronary event. Metabolic syndrome (MetS), according to Third Report of the NCEP/ATP III criteria, and Framingham risk score (FRS) were computed. The cumulative incidence between T0 and T1 for all risk factors was investigated. The incidence rate (person-years) for hypertension, DM, dyslipidemia and hypertriglyceridemia, with a CI95%, were calculated based in the data collected from the medical records. The frequency of risk factor disappearance at T1 (including the absence of treatment in the definition of disappearance), among patients with the risk factor at T0, was also described.

Results: The mean (SD) age at T0 of 151 patients reevaluated after 39 (36.5-42.0) months (T1) was 37.8 (11.1) years old, 75.5% non-white. The cumulative incidence, the incidence rate and the disappearance of some risk factors for CAD are presented in Table 1. The cumulative incidence during follow up were zero for smoking, 3.8% for positive family history for premature CAD, 16.5% for obesity, 18.8% for MetS and 39.1% for abdominal obesity. Eleven (11.7%) of 143 patients with low FRS in T0 were classified in high risk category in T1. Considering the risk factors disappearance, 26.0% with MetS at T0, 16.7% with obesity and 6.3% with abdominal obesity presented without the risk factor at T1. Only 1 (12.5%) patient within the higher risk of coronary event in 10 years (FRS>10%) at T0 “reduced” the risk to <10% in T1.

Conclusion: The authors identified a significant increase in the incidence of CAD risk factors in lupus patients with a follow-up of approximately 3 years. Conditions such as hypertension, obesity and DM presented less fluctuation than dyslipidemia between T0 and T1, raising considerations about the importance of statins use in lupus patients over time.

Table 1. Coronary artery disease risk factors cumulative incidence, incidence rate and disappearance after 39 (37-42) months, in lupus patients

*Incident case/Number of patients without risk factor at T0.

**Number of patients with disappearance of a risk factor/Number of patients with the risk factor at T0.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/incidence-and-variability-of-cardiovascular-risk-factors-in-female-lupus-patients-a-3-year-follow-up/