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Accrual of Atherosclerotic Vascular Events in a Multicenter Inception Systemic Lupus Erythematosus Cohort.
Urowitz, Murray B; Gladman, Dafna D; Farewell, Vernon; Su, Jiandong; Romero-Diaz, Juanita; Bae, Sang-Cheol; Fortin, Paul R; Sanchez-Guerrero, Jorge; Clarke, Ann Elaine; Bernatsky, Sasha; Gordon, Caroline; Hanly, John G; Wallace, Daniel J; Isenberg, David A; Rahman, Anisur; Merrill, Joan T; Ginzler, Ellen; Alarcón, Graciela S; Chatham, W Winn; Petri, Michelle A; Bruce, Ian N; Khamashta, Munther A; Aranow, Cynthia; Dooley, Mary Anne; Manzi, Susan; Ramsey-Goldman, Rosalind; Nived, Ola; Jönsen, Andreas; Steinsson, Kristján; Zoma, Asad A; Ruiz-Irastorza, Guillermo; Lim, S Sam; Kalunian, Kenneth C; Inanç, Murat; van Vollenhoven, Ronald; Ramos-Casals, Manuel; Kamen, Diane L; Jacobsen, Soren; Peschken, Christine A; Askanase, Anca; Stoll, Thomas.
Afiliação
  • Urowitz MB; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and University of Toronto, Toronto, Ontario, Canada.
  • Gladman DD; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and University of Toronto, Toronto, Ontario, Canada.
  • Farewell V; Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.
  • Su J; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and University of Toronto, Toronto, Ontario, Canada.
  • Romero-Diaz J; Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico.
  • Bae SC; Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.
  • Fortin PR; Centre Hospitalier Universitaire de Québec et Université Laval, Quebec City, Quebec, Canada.
  • Sanchez-Guerrero J; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and University of Toronto, Toronto, Ontario, Canada.
  • Clarke AE; University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
  • Bernatsky S; Montreal General Hospital and McGill University Health Centre, Montreal, Quebec, Canada.
  • Gordon C; University of Birmingham College of Medical and Dental Sciences, Birmingham, UK.
  • Hanly JG; Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
  • Wallace DJ; Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California, Los Angeles.
  • Isenberg DA; University College, London, UK.
  • Rahman A; University College, London, UK.
  • Merrill JT; Oklahoma Medical Research Foundation, Oklahoma City.
  • Ginzler E; SUNY Downstate Medical Center, Brooklyn, New York.
  • Alarcón GS; University of Alabama at Birmingham.
  • Chatham WW; University of Alabama at Birmingham.
  • Petri MA; Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Bruce IN; Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Sciences Centre, The University of Manchester, NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
  • Khamashta MA; St Thomas' Hospital and King's College London School of Medicine, London, UK.
  • Aranow C; Feinstein Institute for Medical Research, Manhasset, New York.
  • Dooley MA; University of North Carolina, Chapel Hill.
  • Manzi S; Lupus Center of Excellence, Allegheny Health Network, Pittsburgh, Pennsylvania.
  • Ramsey-Goldman R; Northwestern University Feinberg School of Medicine, Chicago, Illinois.
  • Nived O; Lund University and Skåne University Hospital, Lund, Sweden.
  • Jönsen A; Lund University and Skåne University Hospital, Lund, Sweden.
  • Steinsson K; Fossvogur Landspitali University Hospital Center for Rheumatology Research, Reykjavik, Iceland.
  • Zoma AA; Hairmyres Hospital, East Kilbride, Scotland, UK.
  • Ruiz-Irastorza G; Hospital Universitario Cruces and University of the Basque Country, Barakaldo, Spain.
  • Lim SS; Emory University School of Medicine, Atlanta, Georgia.
  • Kalunian KC; University of California San Diego School of Medicine, La Jolla.
  • Inanç M; Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
  • van Vollenhoven R; Amsterdam University Medical Centers, Amsterdam, Holland.
  • Ramos-Casals M; Institut d'Investigacions Biomèdiques August Pi i Sunyer and Hospital Clínic, Barcelona, Spain.
  • Kamen DL; Medical University of South Carolina, Charleston.
  • Jacobsen S; Copenhagen Lupus and Vasculitis Clinic and Copenhagen University Hospital, Copenhagen, Denmark.
  • Peschken CA; University of Manitoba, Winnipeg, Manitoba, Canada.
  • Askanase A; Hospital for Joint Diseases, New York University, New York, New York.
  • Stoll T; Kantonsspital, Schaffhausen, Switzerland.
Arthritis Rheumatol ; 72(10): 1734-1740, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32515554
ABSTRACT

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.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Fatores de risco Idioma: Inglês Revista: Arthritis Rheumatol Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Canadá

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Fatores de risco Idioma: Inglês Revista: Arthritis Rheumatol Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Canadá