title: Cardiovascular Events in Systemic Lupus Erythematosus: A Nationwide Study in Spain From the RELESSER Registry.
abstract: This article estimates the frequency of cardiovascular (CV) events that occurred after diagnosis in a large Spanish cohort of patients with systemic lupus erythematosus (SLE) and investigates the main risk factors for atherosclerosis. RELESSER is a nationwide multicenter, hospital-based registry of SLE patients. This is a cross-sectional study. Demographic and clinical variables, the presence of traditional risk factors, and CV events were collected. A CV event was defined as a myocardial infarction, angina, stroke, and/or peripheral artery disease. Multiple logistic regression analysis was performed to investigate the possible risk factors for atherosclerosis. From 2011 to 2012, 3658 SLE patients were enrolled. Of these, 374 (10.9%) patients suffered at least a CV event. In 269 (7.4%) patients, the CV events occurred after SLE diagnosis (86.2% women, median [interquartile range] age 54.9 years [43.2-66.1], and SLE duration of 212.0 months [120.8-289.0]). Strokes (5.7%) were the most frequent CV event, followed by ischemic heart disease (3.8%) and peripheral artery disease (2.2%). Multivariate analysis identified age (odds ratio [95% confidence interval], 1.03 [1.02-1.04]), hypertension (1.71 [1.20-2.44]), smoking (1.48 [1.06-2.07]), diabetes (2.2 [1.32-3.74]), dyslipidemia (2.18 [1.54-3.09]), neurolupus (2.42 [1.56-3.75]), valvulopathy (2.44 [1.34-4.26]), serositis (1.54 [1.09-2.18]), antiphospholipid antibodies (1.57 [1.13-2.17]), low complement (1.81 [1.12-2.93]), and azathioprine (1.47 [1.04-2.07]) as risk factors for CV events. We have confirmed that SLE patients suffer a high prevalence of premature CV disease. Both traditional and nontraditional risk factors contribute to this higher prevalence. Although it needs to be verified with future studies, our study also shows-for the first time-an association between diabetes and CV events in SLE patients.
authors.affiliation: On behalf of EAS-SER (Systemic Diseases Study Group of the Spanish Society of Rheumatology) From the UGC Reumatología (AFN), Instituto de Investigación Biomédica (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga; Department of Rheumatology (ÍRF), Dr Negrín General University Hospital, Las Palmas de Gran Canaria, Gran Canaria; Department of Rheumatology (FLL), Gregorio Marañón University Hospital; Department of Rheumatology (MGI), Doce de Octubre University Hospital, Madrid; Department of Rheumatology (JCA), Sierrallana Hospital, Torrelavega; Department of Rheumatology (AOM), Germans Trías i Pujol University Hospital, Badalona; UGC Reumatología (COC), Instituto de Investigación Biomédica (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga; Research Unit of Spanish Society of Rheumatology (MMM), Madrid; Department of Rheumatology (RB), Marqués de Valdecilla University Hospital, Santander; Department of Rheumatology (RMG), Hospital Complex of Ourense, Ourense; Department of Rheumatology (JIR), POVISA Hospital, Vigo; Department of Rheumatology (JBV), Alicante General University Hospital, Alicante; Department of Rheumatology (ETM), La Princesa University Hospital, Madrid; Department of Rheumatology (EUI), Donosti University Hospital, Guipuzcoa; Department of Rheumatology (LHR), Navarra Hospital, Pamplona; Department of Rheumatology (MFG), Juan Canalejo University Hospital, La Coruña; Department of Rheumatology (JN), Bellvitge University Hospital, Barcelona; Department of Rheumatology (ALB), Ramón y Cajal University Hospital, Madrid; Department of Rheumatology (GSS), Marina Baixa University Hospital, Villajoyosa, Alicante; Department of Rheumatology (JAS), Puerta del Hierro-Majadahonda Hospital, Madrid; and University Hospital Complex (JMPR), Instituto de Investigación Biomédica de Vigo (IBIV), Vigo, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Nebro
authors.forename: Íñigo
authors.initials: Í
authors.lastname: Rúa-Figueroa
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: López-Longo
authors.forename: María
authors.initials: M
authors.lastname: Galindo-Izquierdo
authors.forename: Jaime
authors.initials: J
authors.lastname: Calvo-Alén
authors.forename: Alejandro
authors.initials: A
authors.lastname: Olivé-Marqués
authors.forename: Carmen
authors.initials: C
authors.lastname: Ordóñez-Cañizares
authors.forename: María A
authors.initials: MA
authors.lastname: Martín-Martínez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Blanco
authors.forename: Rafael
authors.initials: R
authors.lastname: Melero-González
authors.forename: Jesús
authors.initials: J
authors.lastname: Ibáñez-Rúan
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Bernal-Vidal
authors.forename: Eva
authors.initials: E
authors.lastname: Tomero-Muriel
authors.forename: Esther
authors.initials: E
authors.lastname: Uriarte-Isacelaya
authors.forename: Loreto
authors.initials: L
authors.lastname: Horcada-Rubio
authors.forename: Mercedes
authors.initials: M
authors.lastname: Freire-González
authors.forename: Javier
authors.initials: J
authors.lastname: Narváez
authors.forename: Alina L
authors.initials: AL
authors.lastname: Boteanu
authors.forename: Gregorio
authors.initials: G
authors.lastname: Santos-Soler
authors.forename: José L
authors.initials: JL
authors.lastname: Andreu
authors.forename: José M
authors.initials: JM
authors.lastname: Pego-Reigosa
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D050197:Atherosclerosis / Q000150:complications; D002318:Cardiovascular Diseases / Q000150:complications*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013030:Spain; D044465:White People