title: Impact of Chronic Glucocorticoid Treatment on Cardiovascular Risk Profile in Patients with Systemic Lupus Erythematosus.
abstract: BACKGROUND
  Systemic lupus erythematosus is highly associated with premature atherosclerosis and cardiovascular events. The origin of this subclinical atherosclerosis has been attributed mainly to the inflammatory nature of the disease.
  
  
  OBJECTIVE
  To assess the effect of long-term use of glucocorticoids on cardiovascular risk in patients with systemic lupus erythematosus.
  
  
  METHODS
  We conducted a registry-based retrospective cohort study. We determined 2 periods: (1) Time 0, that is, time of diagnosis and (2) time 1, that is, when the study was finalized. At both times, the cardiovascular risk was evaluated using the Framingham scale and their scores were compared. Afterward, the change magnitude between the 2 times was evaluated and associated with the cumulative glucocorticoids dose.
  
  
  RESULTS
  One hundred one patients were included. The mean ± SD age was 26.5 ± 5 years. Length of disease evolution was of 7.8 ± 4.9 years. There was an 8-point increase in the Framingham score, from -8.1 ± 4 to 0.8 ± 7; P < 0.0001. The correlation between the magnitude of the increase in Framingham score and their corresponding cumulative dose showed a coefficient of 0.88; P < 0.001.
  
  
  CONCLUSIONS
  The glucocorticoids are a primary factor that influences cardiovascular risk. There is a directly proportional relationship between the cumulative glucocorticoid dose and the increase in cardiovascular risk.
authors.affiliation: From the *Departamento de Medicina Interna, Hospital de Especialidades Centro Médico Nacional "La Raza", IMSS, Seris y Zaachila S/N, Colonia La Raza, Delegación Azcapotzalco, Distrito Federal, México; and †Coordinación de Planeación de Infraestructura Médica, Instituto Mexicano del Seguro Social, Colonia Roma, Delegación Cuauhtémoc, Distrito Federal, México.
authors.forename: Fernando Briceño
authors.initials: FB
authors.lastname: Moya
authors.forename: Luis Francisco
authors.initials: LF
authors.lastname: Pineda Galindo
authors.forename: Maximiliano
authors.initials: M
authors.lastname: García de la Peña
mesh_terms: D000293:Adolescent; D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects*; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D005938:Glucocorticoids