Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Certain traditional and disease-related factors have been identified to accelerate atherosclerosis in systemic lupus erythematosus (SLE). Due to the lack of long-term prospective studies, the evolution over time and relative importance of these variables in the development of atherosclerotic cardiovascular events (CVEs) is not known. We aimed to determine the evolution of CVE risk factors over 15 years,
Results: SLE patients had consistently higher rates of CVEs, the difference becoming greater with longer follow up (p=0.0001). CVEs occurred in 41/210 patients (19.5%) and 8/138 controls (5.8%), mostly in the second part (2008-2015) (24/41, 58.5% vs. 17/41, 41.5% in patients, 4 CVEs in each part in controls). Coronary artery disease was more common in SLE (32/210, 15.2% vs. 5/138, 3.6%, p=0.0041). There was no significant difference for cerebrovascular disease (10/210, 4.8% vs. 3/138, 2.2%, p=0.213). SLE [HR=2.8, 95% CI 1.3-6.3], older age and triglycerides>2.8mmol/L were predictive of CAD in the early phase. In the late phase, hypertension, diabetes, dyslipidemia and high BMI were more prominent in patients who suffered a CVE. Time-adjusted disease activity (AMS) was lower in those late phase patients; however their cumulative prednisone dose between 2000-2007 was significantly higher. Of note, 60% of the new hypertension and all new diabetes cases were attributed to glucocoricoids. Thirty-one deaths occurred in patients (10 due to CVEs) and 6 in controls (none due to CVEs); all CVE-related deaths occurred between 2008 and 2015.
Conclusion: SLE patients had a 4-fold increased risk for CVEs and all-cause mortality as compared to healthy controls after 15 years. Disease-related factors dominate cardiovascular risk during the early stages while traditional factors, partially related to corticosteroid treatment, play a significant role later in disease course.
To cite this abstract in AMA style:Tselios K, Gladman DD, Su J, Ace O, Urowitz M. Long-Term Evolution of Risk Factors for Atherosclerotic Cardiovascular Events in Systemic Lupus Erythematosus in a Large Case Control Cohort Study [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/long-term-evolution-of-risk-factors-for-atherosclerotic-cardiovascular-events-in-systemic-lupus-erythematosus-in-a-large-case-control-cohort-study/. Accessed November 17, 2019.
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