title: The pulse-mass index as a predictor of cardiovascular events in women with systemic lupus erythematosus.
abstract: BACKGROUND
  Patients with systemic lupus erythematosus (SLE) have 3times the risk of death compared to the rest of the population, with cardiovascular events (CVD) being one of the main causes. Índices such as waist-height (W-Ht I), waist-hip (W-Hp I) and pulse-mass (PMI) predict CVD, though the behaviour is unknown in patients with SLE. The aim of this study was to determine the prognostic value of PMI in the development of CVD in premenopausal women with SLE.
  
  
  METHODS
  Cohort study. Included were premenopausal women with SLE without prior CVD; excluded were those patients with antiphospholipid syndrome (APS), pregnancy, thyroid disease, recent liposuction, and chronic kidney disease. Exposure variables were: PMI, W-Ht I, W-Hp I and metabolic syndrome at onset of the cohort. Considered confounding variables were time of evolution, disease activity, cumulative damage and treatment. Through semi-annual appointments, accident and emergency admittance and hospitalisation records the CVD were screened. Analysis was performed with Cox for proportional hazards and survival with Kaplan Meier.
  
  
  RESULTS
  We included 238 women with a median age of 31 (18-52) years, with a follow-up of 8years. We identified 22 (9.6%) cases of CVD. In the Cox proportional hazards analysis, the prognostic variables were: PMI with HR=8.1 (95% CI: 1.1-65), metabolic syndrome with 2.4 (95% CI: 1-5.8), cumulative damage with HR=1.5 (95% CI: 1.1-2.2) and body fat percentage HR=2.8 (95% CI: 1.1-6.9) CONCLUSIONS: The PMI is a better predictor factor of CVD in women with SLE.
authors.affiliation: Departamento de Vigilancia Epidemiológica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
authors.forename: Elsy Aidé
authors.initials: EA
authors.lastname: García-Villegas
authors.affiliation: Departamento de Cardiopatías Congénitas, Hospital de Cardiología Centro Médico Nacional Siglo XXI, Ciudad de México, México. Electronic address: horacioinvestigacion@hotmail.com.
authors.forename: Horacio
authors.initials: H
authors.lastname: Márquez-González
authors.affiliation: Clínica de Vasculitis, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México, México.
authors.forename: Luis Felipe
authors.initials: LF
authors.lastname: Flores-Suárez
authors.affiliation: Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México.
authors.forename: Antonio Rafael
authors.initials: AR
authors.lastname: Villa-Romero
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006339:Heart Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D017697:Premenopause; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
keywords: Anthropometric; Antropometría; Cardiovascular disease; Enfermedad cardiovascular; Factores de riesgo tradicionales; Lupus eritematoso sistémico; Metabolic syndrome; Pulse-mass index; Systemic lupus erythematosus; Síndrome metabólico; Traditional risk factors; Índice pulso masa