title: The risk of pulmonary embolism and deep venous thrombosis in systemic lupus erythematosus: A general population-based study.
abstract: OBJECTIVE
  To estimate the future risk and time trends of newly diagnosed venous thromboembolism (VTE) in individuals with incident systemic lupus erythematosus (SLE) in the general population.
  
  
  METHODS
  Using a population-based database that includes all residents of British Columbia, Canada we conducted a study cohort of all patients with incident SLE and up to 10 age-, sex-, and entry-time-matched individuals from the general population. We compared incidence rates of pulmonary embolism (PE), deep venous thrombosis (DVT), and VTE between the two groups according to SLE disease duration. We calculated hazards ratios (HR), adjusting for confounders.
  
  
  RESULTS
  Among 4863 individuals with SLE (86% female; mean age, 48.9 years), the incidence rates (IRs) of PE, DVT, and VTE were 2.58, 3.33, and 5.32 per 1000 person-years, respectively, whereas the corresponding rates in the comparison cohort were 0.67, 0.57, and 1.11 per 1000 person-years. Compared with non-SLE individuals, the multivariable HRs among SLE patients were 3.04 (95% CI: 2.08-4.45), 4.46 (95% CI: 3.11-6.41), and 3.55 (95% CI: 2.69-4.69), respectively. The age-, sex-, and entry-time-matched HRs for PE, DVT, and VTE were highest during the first year after SLE diagnosis [13.57 (95% CI: 7.66-24.02), 11.13 (95% CI: 6.55-18.90), and 12.89 (95% CI: 8.56-19.41), respectively].
  
  
  CONCLUSIONS
  These findings provide population-based evidence that patients with SLE have a substantially increased risk of VTE, especially in the first year after SLE diagnosis. Awareness and increased vigilance of this potentially fatal, but preventable, complication is recommended.
authors.affiliation: Division of Rheumatology, Department of Medicine, Arthritis Research Canada, University of British Columbia, Richmond, British Columbia, Canada; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: azubieta@arthritisresearch.ca.
authors.forename: J Antonio
authors.initials: JA
authors.lastname: Aviña-Zubieta
authors.affiliation: Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Kateryna
authors.initials: K
authors.lastname: Vostretsova
authors.affiliation: Division of Rheumatology, Department of Medicine, Arthritis Research Canada, University of British Columbia, Richmond, British Columbia, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mary A
authors.initials: MA
authors.lastname: De Vera
authors.affiliation: Division of Rheumatology, Department of Medicine, Arthritis Research Canada, University of British Columbia, Richmond, British Columbia, Canada.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Sayre
authors.affiliation: Division of Rheumatology, Department of Medicine, Arthritis Research Canada, University of British Columbia, Richmond, British Columbia, Canada; Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Hyon K
authors.initials: HK
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology*; D012306:Risk; D020246:Venous Thrombosis / Q000453:epidemiology*
keywords: Cardiovascular disease; Deep venous thrombosis; Pulmonary embolism; Risk; Systemic lupus erythematosus