TY - JOUR
T1 - Accrual of Atherosclerotic Vascular Events in a Multicenter Inception Systemic Lupus Erythematosus Cohort
AU - Urowitz, Murray B.
AU - Gladman, Dafna D.
AU - Farewell, Vernon
AU - Su, Jiandong
AU - Romero-Diaz, Juanita
AU - Bae, Sang Cheol
AU - Fortin, Paul R.
AU - Sanchez-Guerrero, Jorge
AU - Clarke, Ann Elaine
AU - Bernatsky, Sasha
AU - Gordon, Caroline
AU - Hanly, John G.
AU - Wallace, Daniel J.
AU - Isenberg, David A.
AU - Rahman, Anisur
AU - Merrill, Joan T.
AU - Ginzler, Ellen
AU - Alarcón, Graciela S.
AU - Chatham, W. Winn
AU - Petri, Michelle A.
AU - Bruce, Ian N.
AU - Khamashta, Munther A.
AU - Aranow, Cynthia
AU - Dooley, Mary Anne
AU - Manzi, Susan
AU - Ramsey-Goldman, Rosalind
AU - Nived, Ola
AU - Jönsen, Andreas
AU - Steinsson, Kristján
AU - Zoma, Asad A.
AU - Ruiz-Irastorza, Guillermo
AU - Lim, S. Sam
AU - Kalunian, Kenneth C.
AU - Ỉnanç, Murat
AU - van Vollenhoven, Ronald
AU - Ramos-Casals, Manuel
AU - Kamen, Diane L.
AU - Jacobsen, Soren
AU - Peschken, Christine A.
AU - Askanase, Anca
AU - Stoll, Thomas
N1 - Publisher Copyright:
© 2020, American College of Rheumatology
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Objective: In previous studies, atherosclerotic vascular events (AVEs) were shown to occur in ~10% of patients with systemic lupus erythematosus (SLE). We undertook this study to investigate the annual occurrence and potential risk factors for AVEs in a multinational, multiethnic inception cohort of patients with SLE. Methods: A large 33-center cohort of SLE patients was followed up yearly between 1999 and 2017. AVEs were attributed to atherosclerosis based on SLE being inactive at the time of the AVE as well as typical atherosclerotic changes observed on imaging or pathology reports and/or evidence of atherosclerosis elsewhere. Analyses included descriptive statistics, rate of AVEs per 1,000 patient-years, and univariable and multivariable relative risk regression models. Results: Of the 1,848 patients enrolled in the cohort, 1,710 had ≥1 follow-up visit after enrollment, for a total of 13,666 patient-years. Of these 1,710 patients, 3.6% had ≥1 AVEs attributed to atherosclerosis, for an event rate of 4.6 per 1,000 patient-years. In multivariable analyses, lower AVE rates were associated with antimalarial treatment (hazard ratio [HR] 0.54 [95% confidence interval (95% CI) 0.32–0.91]), while higher AVE rates were associated with any prior vascular event (HR 4.00 [95% CI 1.55–10.30]) and a body mass index of >40 kg/m2 (HR 2.74 [95% CI 1.04–7.18]). A prior AVE increased the risk of subsequent AVEs (HR 5.42 [95% CI 3.17–9.27], P < 0.001). Conclusion: The prevalence of AVEs and the rate of AVE accrual demonstrated in the present study is much lower than that seen in previously published data. This may be related to better control of both the disease activity and classic risk factors.
AB - Objective: In previous studies, atherosclerotic vascular events (AVEs) were shown to occur in ~10% of patients with systemic lupus erythematosus (SLE). We undertook this study to investigate the annual occurrence and potential risk factors for AVEs in a multinational, multiethnic inception cohort of patients with SLE. Methods: A large 33-center cohort of SLE patients was followed up yearly between 1999 and 2017. AVEs were attributed to atherosclerosis based on SLE being inactive at the time of the AVE as well as typical atherosclerotic changes observed on imaging or pathology reports and/or evidence of atherosclerosis elsewhere. Analyses included descriptive statistics, rate of AVEs per 1,000 patient-years, and univariable and multivariable relative risk regression models. Results: Of the 1,848 patients enrolled in the cohort, 1,710 had ≥1 follow-up visit after enrollment, for a total of 13,666 patient-years. Of these 1,710 patients, 3.6% had ≥1 AVEs attributed to atherosclerosis, for an event rate of 4.6 per 1,000 patient-years. In multivariable analyses, lower AVE rates were associated with antimalarial treatment (hazard ratio [HR] 0.54 [95% confidence interval (95% CI) 0.32–0.91]), while higher AVE rates were associated with any prior vascular event (HR 4.00 [95% CI 1.55–10.30]) and a body mass index of >40 kg/m2 (HR 2.74 [95% CI 1.04–7.18]). A prior AVE increased the risk of subsequent AVEs (HR 5.42 [95% CI 3.17–9.27], P < 0.001). Conclusion: The prevalence of AVEs and the rate of AVE accrual demonstrated in the present study is much lower than that seen in previously published data. This may be related to better control of both the disease activity and classic risk factors.
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U2 - 10.1002/art.41392
DO - 10.1002/art.41392
M3 - Article
C2 - 32515554
AN - SCOPUS:85089782157
SN - 2326-5191
VL - 72
SP - 1734
EP - 1740
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 10
ER -