Predictors of cardiovascular damage in patients with systemic lupus erythematosus: data from LUMINA (LXVIII), a multiethnic US cohort

Rheumatology (Oxford). 2009 Jul;48(7):817-22. doi: 10.1093/rheumatology/kep102. Epub 2009 May 19.

Abstract

Objective: To determine the features predictive of atherosclerotic cardiovascular damage in patients with SLE.

Methods: SLE LUMINA (LUpus in MInorities: NAture vs nurture) patients (n = 637), aged >or=16 years, disease duration <or=5 years at baseline (T0), of African-American, Hispanic and Caucasian ethnicity were studied. Atherosclerotic cardiovascular damage was defined by the following items of the SLICC Damage Index (SDI) cardiovascular domain: angina or coronary artery by pass surgery, myocardial infarction and/or congestive heart failure; factors associated with its occurrence were examined by univariable and multivariable regression analyses.

Results: Forty-three (6.8%) of 637 patients developed cardiovascular damage over a mean +/- S.D. total disease duration of 6.6 +/- 3.6 years. Nearly 90% of the patients were women with a mean +/- s.d. age of 36.5 (12.6) years; all ethnic groups were represented. By multivariable analyses, after adjusting for the cardiovascular manifestations present, age [odds ratio (OR) = 1.06; 95% CI 1.03, 1.09], male gender (OR = 3.57; 95% CI 1.35, 9.09) SDI at baseline (OR = 1.28; 95% CI 1.09, 1.50) and CRP levels [highest tertile (OR = 2.63; 95% CI 1.17, 5.91)] were associated with the occurrence of cardiovascular damage, whereas the number of years of education was negatively associated with such outcome (OR = 0.85; 95% CI 0.74, 0.94).

Conclusions: Our data suggest that atherosclerotic cardiovascular damage in SLE is multifactorial; traditional (age, gender) and disease-related factors (CRP levels, SDI at baseline) appear to be important contributors to such an occurrence. Tight control of the inflammatory process must be achieved to prevent it.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans
  • Age Factors
  • Aged
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / mortality
  • Educational Status
  • Female
  • Hispanic or Latino
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / ethnology
  • Lupus Erythematosus, Systemic / mortality
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / ethnology
  • Myocardial Infarction / mortality
  • Odds Ratio
  • Risk Factors
  • Sex Factors
  • Whites

Substances

  • C-Reactive Protein