Prevalence of cardiovascular events in a population-based registry of patients with systemic lupus erythematosus.
Cardiovascular disease
Cerebrovascular accident
Epidemiology
Myocardial infarction
Systemic lupus erythematosus
Journal
Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438
Informations de publication
Date de publication:
14 Sep 2024
14 Sep 2024
Historique:
received:
21
06
2024
accepted:
03
09
2024
medline:
14
9
2024
pubmed:
14
9
2024
entrez:
13
9
2024
Statut:
epublish
Résumé
The Manhattan Lupus Surveillance Program (MLSP), a population-based retrospective registry of patients with systemic lupus erythematosus (SLE), was used to investigate the prevalence of cardiovascular disease events (CVE) and compare rates among sex, age and race/ethnicity to population-based controls. Patients with prevalent SLE in 2007 aged ≥ 20 years in the MLSP were included. CVE required documentation of a myocardial infarction or cerebrovascular accident. We calculated crude risk ratios and adjusted risk ratios (ARR) controlling for sex, age group, race and ethnicity, and years since diagnosis. Data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) and the 2013-2014 NYC Health and Nutrition Examination Survey (NYC HANES) were used to calculate expected CVE prevalence by multiplying NHANES and NYC HANES estimates by strata-specific counts of patients with SLE. Crude prevalence ratios (PRs) using national and NYC estimates and age standardized prevalence ratios (ASPRs) using national estimates were calculated. CVE occurred in 13.9% of 1,285 MLSP patients with SLE, and risk was increased among men (ARR:1.7, 95%CI:1.2-2.5) and older adults (age > 60 ARR:2.5, 95%CI:1.7-3.8). Compared with non-Hispanic Asian patients, CVE risk was elevated among Hispanic/Latino (ARR:3.1, 95%CI:1.4-7.0) and non-Hispanic Black (ARR:3.5, 95%CI1.6-7.9) patients as well as those identified as non-Hispanic and in another or multiple racial groups (ARR:4.2, 95%CI:1.1-15.8). Overall, CVE prevalence was higher among patients with SLE than nationally (ASPR:3.1, 95%CI:3.0-3.1) but did not differ by sex. Compared with national race and ethnicity-stratified estimates, CVE among patients with SLE was highest among Hispanics/Latinos (ASPR:4.3, 95%CI:4.2-4.4). CVE was also elevated among SLE registry patients compared with all NYC residents. Comparisons with age-stratified national estimates revealed PRs of 6.4 (95%CI:6.2-6.5) among patients aged 20-49 years and 2.2 (95%CI:2.1-2.2) among those ≥ 50 years. Male (11.3, 95%CI:10.5-12.1), Hispanic/Latino (10.9, 95%CI:10.5-11.4) and non-Hispanic Black (6.2, 95%CI:6.0-6.4) SLE patients aged 20-49 had the highest CVE prevalence ratios. These population-based estimates of CVE in a diverse registry of patients with SLE revealed increased rates among younger male, Hispanic/Latino and non-Hispanic Black patients. These findings reinforce the need to appropriately screen for CVD among all SLE patients but particularly among these high-risk patients.
Sections du résumé
BACKGROUND
BACKGROUND
The Manhattan Lupus Surveillance Program (MLSP), a population-based retrospective registry of patients with systemic lupus erythematosus (SLE), was used to investigate the prevalence of cardiovascular disease events (CVE) and compare rates among sex, age and race/ethnicity to population-based controls.
METHODS
METHODS
Patients with prevalent SLE in 2007 aged ≥ 20 years in the MLSP were included. CVE required documentation of a myocardial infarction or cerebrovascular accident. We calculated crude risk ratios and adjusted risk ratios (ARR) controlling for sex, age group, race and ethnicity, and years since diagnosis. Data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) and the 2013-2014 NYC Health and Nutrition Examination Survey (NYC HANES) were used to calculate expected CVE prevalence by multiplying NHANES and NYC HANES estimates by strata-specific counts of patients with SLE. Crude prevalence ratios (PRs) using national and NYC estimates and age standardized prevalence ratios (ASPRs) using national estimates were calculated.
RESULTS
RESULTS
CVE occurred in 13.9% of 1,285 MLSP patients with SLE, and risk was increased among men (ARR:1.7, 95%CI:1.2-2.5) and older adults (age > 60 ARR:2.5, 95%CI:1.7-3.8). Compared with non-Hispanic Asian patients, CVE risk was elevated among Hispanic/Latino (ARR:3.1, 95%CI:1.4-7.0) and non-Hispanic Black (ARR:3.5, 95%CI1.6-7.9) patients as well as those identified as non-Hispanic and in another or multiple racial groups (ARR:4.2, 95%CI:1.1-15.8). Overall, CVE prevalence was higher among patients with SLE than nationally (ASPR:3.1, 95%CI:3.0-3.1) but did not differ by sex. Compared with national race and ethnicity-stratified estimates, CVE among patients with SLE was highest among Hispanics/Latinos (ASPR:4.3, 95%CI:4.2-4.4). CVE was also elevated among SLE registry patients compared with all NYC residents. Comparisons with age-stratified national estimates revealed PRs of 6.4 (95%CI:6.2-6.5) among patients aged 20-49 years and 2.2 (95%CI:2.1-2.2) among those ≥ 50 years. Male (11.3, 95%CI:10.5-12.1), Hispanic/Latino (10.9, 95%CI:10.5-11.4) and non-Hispanic Black (6.2, 95%CI:6.0-6.4) SLE patients aged 20-49 had the highest CVE prevalence ratios.
CONCLUSIONS
CONCLUSIONS
These population-based estimates of CVE in a diverse registry of patients with SLE revealed increased rates among younger male, Hispanic/Latino and non-Hispanic Black patients. These findings reinforce the need to appropriately screen for CVD among all SLE patients but particularly among these high-risk patients.
Identifiants
pubmed: 39272198
doi: 10.1186/s13075-024-03395-6
pii: 10.1186/s13075-024-03395-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
160Subventions
Organisme : CDC HHS
ID : U01DP006700
Pays : United States
Organisme : CDC HHS
ID : U01DP006700
Pays : United States
Organisme : CDC HHS
ID : U58/DP002827
Pays : United States
Organisme : CDC HHS
ID : U01DP006700
Pays : United States
Informations de copyright
© 2024. The Author(s).
Références
Fors Nieves CE, Izmirly PM. Mortality in systemic Lupus Erythematosus: an updated review. Curr Rheumatol Rep. 2016;18(4):21.
pubmed: 26984805
doi: 10.1007/s11926-016-0571-2
Izmirly PM, Wan I, Sahl S, Buyon JP, Belmont HM, Salmon JE, et al. The incidence and prevalence of systemic Lupus Erythematosus in New York County (Manhattan), New York: the Manhattan Lupus Surveillance Program. Arthritis Rheumatol. 2017;69(10):2006–17.
pubmed: 28891252
pmcid: 11102806
doi: 10.1002/art.40192
Thomas G, Mancini J, Jourde-Chiche N, Sarlon G, Amoura Z, Harlé JR, et al. Mortality associated with systemic lupus erythematosus in France assessed by multiple-cause-of-death analysis. Arthritis Rheumatol. 2014;66(9):2503–11.
pubmed: 24910304
doi: 10.1002/art.38731
Urowitz MB, Bookman AA, Koehler BE, Gordon DA, Smythe HA, Ogryzlo MA. The bimodal mortality pattern of systemic lupus erythematosus. Am J Med. 1976;60(2):221–5.
pubmed: 1251849
doi: 10.1016/0002-9343(76)90431-9
Taylor T, Anastasiou C, Ja C, Rush S, Trupin L, Dall’Era M, et al. Causes of death among individuals with systemic lupus erythematosus by race and ethnicity: a Population-based study. Arthritis Care Res (Hoboken). 2023;75(1):61–8.
pubmed: 35904969
doi: 10.1002/acr.24988
Esdaile JM, Abrahamowicz M, Grodzicky T, Li Y, Panaritis C, du Berger R, et al. Traditional Framingham risk factors fail to fully account for accelerated atherosclerosis in systemic lupus erythematosus. Arthritis Rheum. 2001;44(10):2331–7.
pubmed: 11665973
doi: 10.1002/1529-0131(200110)44:10<2331::AID-ART395>3.0.CO;2-I
Magder LS, Petri M. Incidence of and risk factors for adverse cardiovascular events among patients with systemic lupus erythematosus. Am J Epidemiol. 2012;176(8):708–19.
pubmed: 23024137
pmcid: 3571250
doi: 10.1093/aje/kws130
Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2021. NCHS Data Brief. 2022(456):1–8.
Hak AE, Karlson EW, Feskanich D, Stampfer MJ, Costenbader KH. Systemic lupus erythematosus and the risk of cardiovascular disease: results from the nurses’ Health Study. Arthritis Rheum. 2009;61(10):1396–402.
pubmed: 19790130
pmcid: 2909444
doi: 10.1002/art.24537
Yazdany J, Pooley N, Langham J, Nicholson L, Langham S, Embleton N et al. Systemic lupus erythematosus; stroke and myocardial infarction risk: a systematic review and meta-analysis. RMD Open. 2020;6(2).
Manzi S, Meilahn EN, Rairie JE, Conte CG, Medsger TA Jr., Jansen-McWilliams L, et al. Age-specific incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham Study. Am J Epidemiol. 1997;145(5):408–15.
pubmed: 9048514
doi: 10.1093/oxfordjournals.aje.a009122
Skaggs BJ, Hahn BH, McMahon M. Accelerated atherosclerosis in patients with SLE–mechanisms and management. Nat Rev Rheumatol. 2012;8(4):214–23.
pubmed: 22331061
pmcid: 3765069
doi: 10.1038/nrrheum.2012.14
Izmirly PM, Ferucci ED, Somers EC, Wang L, Lim SS, Drenkard C et al. Incidence rates of systemic lupus erythematosus in the USA: estimates from a meta-analysis of the Centers for Disease Control and Prevention national lupus registries. Lupus Sci Med. 2021;8(1).
Izmirly PM, Parton H, Wang L, McCune WJ, Lim SS, Drenkard C, et al. Prevalence of systemic Lupus Erythematosus in the United States: estimates from a Meta-analysis of the Centers for Disease Control and Prevention National Lupus Registries. Arthritis Rheumatol. 2021;73(6):991–6.
pubmed: 33474834
pmcid: 8169527
doi: 10.1002/art.41632
Gianfrancesco MA, Dall’Era M, Murphy LB, Helmick CG, Li J, Rush S, et al. Mortality among minority populations with systemic Lupus Erythematosus, including Asian and Hispanic/Latino persons - California, 2007–2017. MMWR Morb Mortal Wkly Rep. 2021;70(7):236–9.
pubmed: 33600382
pmcid: 7891689
doi: 10.15585/mmwr.mm7007a2
Barbhaiya M, Feldman CH, Guan H, Gómez-Puerta JA, Fischer MA, Solomon DH, et al. Race/Ethnicity and Cardiovascular events among patients with systemic Lupus Erythematosus. Arthritis Rheumatol. 2017;69(9):1823–31.
pubmed: 28598016
pmcid: 6143392
doi: 10.1002/art.40174
Garg S, Bartels CM, Bao G, Helmick CG, Drenkard C, Lim SS. Timing and predictors of Incident Cardiovascular Disease in systemic Lupus Erythematosus: risk occurs early and highlights racial disparities. J Rheumatol. 2023;50(1):84–92.
pubmed: 35914786
doi: 10.3899/jrheum.220279
Mok CC, Tang SS, To CH, Petri M. Incidence and risk factors of thromboembolism in systemic lupus erythematosus: a comparison of three ethnic groups. Arthritis Rheum. 2005;52(9):2774–82.
pubmed: 16142761
doi: 10.1002/art.21224
Rhew EY, Manzi SM, Dyer AR, Kao AH, Danchenko N, Barinas-Mitchell E, et al. Differences in subclinical cardiovascular disease between African American and caucasian women with systemic lupus erythematosus. Transl Res. 2009;153(2):51–9.
pubmed: 19138649
doi: 10.1016/j.trsl.2008.11.006
Scalzi LV, Hollenbeak CS, Wang L. Racial disparities in age at time of cardiovascular events and cardiovascular-related death in patients with systemic lupus erythematosus. Arthritis Rheum. 2010;62(9):2767–75.
pubmed: 20506536
pmcid: 2946465
doi: 10.1002/art.27551
Toloza SM, Uribe AG, McGwin G Jr., Alarcón GS, Fessler BJ, Bastian HM, et al. Systemic lupus erythematosus in a multiethnic US cohort (LUMINA). XXIII. Baseline predictors of vascular events. Arthritis Rheum. 2004;50(12):3947–57.
pubmed: 15593203
doi: 10.1002/art.20622
Guttmann A, Denvir B, Aringer M, Buyon JP, Belmont HM, Sahl S, et al. Evaluation of the EULAR/American College of Rheumatology Classification Criteria for systemic Lupus Erythematosus in a Population-based Registry. Arthritis Care Res (Hoboken). 2023;75(5):1007–16.
pubmed: 35638708
doi: 10.1002/acr.24960
Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725.
pubmed: 9324032
doi: 10.1002/art.1780400928
Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25(11):1271–7.
pubmed: 7138600
doi: 10.1002/art.1780251101
Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the systemic Lupus International collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677–86.
pubmed: 22553077
pmcid: 3409311
doi: 10.1002/art.34473
Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis. 2019;78(9):1151–9.
pubmed: 31383717
doi: 10.1136/annrheumdis-2018-214819
Denvir B, Carlucci PM, Corbitt K, Buyon JP, Belmont HM, Gold HT, et al. Prevalence of concomitant rheumatologic diseases and autoantibody specificities among racial and ethnic groups in SLE patients. Front Epidemiol. 2024;4:1334859.
pubmed: 38516120
pmcid: 10956350
doi: 10.3389/fepid.2024.1334859
New York City Health and Nutrition Examination Survey (NYC HANES 2013–, NYC Health Department. 2014). 2013-14. https://med.nyu.edu/departments-institutes/population-health/divisions-sections-centers/epidemiology/center-innovation-measuring-population-health/new-york-city-health-nutrition-examination-survey/datasets-resources . Accessed: July 23, 2021.
National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Centers for Disease Control and Prevention (CDC). 2009–2010. https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/default.aspx?BeginYear=2009 . Accessed: September 30, 2021.
Aviña-Zubieta JA, To F, Vostretsova K, De Vera M, Sayre EC, Esdaile JM. Risk of myocardial infarction and stroke in newly diagnosed systemic lupus erythematosus: a General Population-based study. Arthritis Care Res (Hoboken). 2017;69(6):849–56.
pubmed: 28129475
doi: 10.1002/acr.23018
Katz G, Smilowitz NR, Blazer A, Clancy R, Buyon JP, Berger JS. Systemic Lupus Erythematosus and Increased Prevalence of Atherosclerotic Cardiovascular Disease in Hospitalized Patients. Mayo Clin Proc. 2019;94(8):1436-43.
Lim SY, Bae EH, Han KD, Jung JH, Choi HS, Kim HY, et al. Systemic lupus erythematosus is a risk factor for cardiovascular disease: a nationwide, population-based study in Korea. Lupus. 2018;27(13):2050–6.
pubmed: 30282562
doi: 10.1177/0961203318804883
Lin CY, Shih CC, Yeh CC, Chou WH, Chen TL, Liao CC. Increased risk of acute myocardial infarction and mortality in patients with systemic lupus erythematosus: two nationwide retrospective cohort studies. Int J Cardiol. 2014;176(3):847–51.
pubmed: 25156834
doi: 10.1016/j.ijcard.2014.08.006
Ward MM. Premature morbidity from cardiovascular and cerebrovascular diseases in women with systemic lupus erythematosus. Arthritis Rheum. 1999;42(2):338–46.
pubmed: 10025929
doi: 10.1002/1529-0131(199902)42:2<338::AID-ANR17>3.0.CO;2-U
Asanuma Y, Oeser A, Shintani AK, Turner E, Olsen N, Fazio S, et al. Premature coronary-artery atherosclerosis in systemic lupus erythematosus. N Engl J Med. 2003;349(25):2407–15.
pubmed: 14681506
doi: 10.1056/NEJMoa035611
Reynolds HR, Buyon J, Kim M, Rivera TL, Izmirly P, Tunick P, et al. Association of plasma soluble E-selectin and adiponectin with carotid plaque in patients with systemic lupus erythematosus. Atherosclerosis. 2010;210(2):569–74.
pubmed: 20044088
doi: 10.1016/j.atherosclerosis.2009.12.007
Roman MJ, Shanker BA, Davis A, Lockshin MD, Sammaritano L, Simantov R, et al. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med. 2003;349(25):2399–406.
pubmed: 14681505
doi: 10.1056/NEJMoa035471
Conrad N, Verbeke G, Molenberghs G, Goetschalckx L, Callender T, Cambridge G, et al. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK. Lancet. 2022;400(10354):733–43.
pubmed: 36041475
doi: 10.1016/S0140-6736(22)01349-6
Schoenfeld SR, Kasturi S, Costenbader KH. The epidemiology of atherosclerotic cardiovascular disease among patients with SLE: a systematic review. Semin Arthritis Rheum. 2013;43(1):77–95.
pubmed: 23422269
doi: 10.1016/j.semarthrit.2012.12.002
Mihailovic J, Ribi C, Chizzolini C, Trendelenburg M, Von Kempis J, Dahdal S, et al. Worse cardiovascular and renal outcome in male SLE patients. Sci Rep. 2023;13(1):18628.
pubmed: 37903784
pmcid: 10616173
doi: 10.1038/s41598-023-45171-7
Arkema EV, Svenungsson E, Von Euler M, Sjöwall C, Simard JF. Stroke in systemic lupus erythematosus: a Swedish population-based cohort study. Ann Rheum Dis. 2017;76(9):1544–9.
pubmed: 28400384
doi: 10.1136/annrheumdis-2016-210973
Barbhaiya M, Feldman CH, Chen SK, Guan H, Fischer MA, Everett BM, et al. Comparative risks of Cardiovascular Disease in patients with systemic Lupus Erythematosus, Diabetes Mellitus, and in General Medicaid recipients. Arthritis Care Res (Hoboken). 2020;72(10):1431–9.
pubmed: 32475049
doi: 10.1002/acr.24328
Wang IK, Muo CH, Chang YC, Liang CC, Lin SY, Chang CT, et al. Risks, subtypes, and hospitalization costs of stroke among patients with systemic lupus erythematosus: a retrospective cohort study in Taiwan. J Rheumatol. 2012;39(8):1611–8.
pubmed: 22753653
doi: 10.3899/jrheum.111510
Crosslin KL, Wiginton KL. Sex differences in disease severity among patients with systemic lupus erythematosus. Gend Med. 2011;8(6):365–71.
pubmed: 22153881
doi: 10.1016/j.genm.2011.10.003
Kao AH, Wasko MC, Krishnaswami S, Wagner J, Edmundowicz D, Shaw P, et al. C-reactive protein and coronary artery calcium in asymptomatic women with systemic lupus erythematosus or rheumatoid arthritis. Am J Cardiol. 2008;102(6):755–60.
pubmed: 18774002
pmcid: 2563802
doi: 10.1016/j.amjcard.2008.04.059
Liou TH, Huang SW, Lin JW, Chang YS, Wu CW, Lin HW. Risk of stroke in patients with rheumatism: a nationwide longitudinal population-based study. Sci Rep. 2014;4:5110.
pubmed: 24898360
pmcid: 4046260
doi: 10.1038/srep05110
Tektonidou MG, Kravvariti E, Konstantonis G, Tentolouris N, Sfikakis PP, Protogerou A. Subclinical atherosclerosis in systemic Lupus Erythematosus: comparable risk with diabetes Mellitus and Rheumatoid Arthritis. Autoimmun Rev. 2017;16(3):308–12.
pubmed: 28147263
doi: 10.1016/j.autrev.2017.01.009
Goff DC Jr., Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. Circulation. 2014;129(25 Suppl 2):S49–73.
pubmed: 24222018
Lloyd-Jones DM, Braun LT, Ndumele CE, Smith SC Jr., Sperling LS, Virani SS, et al. Use of Risk Assessment Tools to Guide decision-making in the primary Prevention of Atherosclerotic Cardiovascular Disease: a Special Report from the American Heart Association and American College of Cardiology. Circulation. 2019;139(25):e1162–77.
pubmed: 30586766
doi: 10.1161/CIR.0000000000000638
Hippisley-Cox J, Coupland C, Brindle P. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study. BMJ. 2017;357:j2099.
pubmed: 28536104
pmcid: 5441081
doi: 10.1136/bmj.j2099
Zhu L, Singh M, Lele S, Sahakian L, Grossman J, Hahn B et al. Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus. Lupus Sci Med. 2022;9(1).
Choi MY, Guan H, Yoshida K, Paudel M, Kargere BA, Li D, et al. Personalizing cardiovascular risk prediction for patients with systemic lupus erythematosus. Semin Arthritis Rheum. 2024;67:152468.
pubmed: 38788567
doi: 10.1016/j.semarthrit.2024.152468
Doria A, Shoenfeld Y, Wu R, Gambari PF, Puato M, Ghirardello A, et al. Risk factors for subclinical atherosclerosis in a prospective cohort of patients with systemic lupus erythematosus. Ann Rheum Dis. 2003;62(11):1071–7.
pubmed: 14583570
pmcid: 1754370
doi: 10.1136/ard.62.11.1071
Kauh TJ, Read JG, Scheitler AJ. The critical role of Racial/Ethnic Data Disaggregation for Health Equity. Popul Res Policy Rev. 2021;40(1):1–7.
pubmed: 33437108
pmcid: 7791160
doi: 10.1007/s11113-020-09631-6