scholarly journals Accrual of Atherosclerotic Vascular Events in a Multicenter Inception Systemic Lupus Erythematosus Cohort

2020 ◽  
Vol 72 (10) ◽  
pp. 1734-1740 ◽  
Author(s):  
Murray B. Urowitz ◽  
Dafna D. Gladman ◽  
Vernon Farewell ◽  
Jiandong Su ◽  
Juanita Romero-Diaz ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Vascular Events

scholarly journals Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXIII. Baseline predictors of vascular events

2004 ◽  
Vol 50 (12) ◽  
pp. 3947-3957 ◽  
Author(s):  
Sergio M. A. Toloza ◽  
América G. Uribe ◽  
Gerald McGwin ◽  
Graciela S. Alarcón ◽  
Barri J. Fessler ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Vascular Events

Vascular events in hypertensive patients with systemic lupus erythematosus

Lupus ◽  
2000 ◽  
Vol 9 (9) ◽  
pp. 672-675 ◽  
Author(s):  
P Rahman ◽  
S Aguero ◽  
D D Gladman ◽  
D Hallett ◽  
M B Urowitz
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Vascular Events ◽  
Hypertensive Patients

scholarly journals Impact of the new American College of Cardiology/American Heart Association definition of hypertension on atherosclerotic vascular events in systemic lupus erythematosus

2020 ◽  
Vol 79 (5) ◽  
pp. 612-617 ◽  
Author(s):  
Konstantinos Tselios ◽  
Dafna D Gladman ◽  
Jiandong Su ◽  
Murray Urowitz
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Cerebrovascular Event ◽  
Systemic Lupus ◽  
Vascular Events

BackgroundThe 2017 American College of Cardiology/American Heart Association guidelines defined hypertension at ≥130/80 mm Hg. Studies on patients with connective tissue diseases were not considered. Our aim was to assess the impact of this definition on atherosclerotic vascular events (AVEs) in systemic lupus erythematosus.Patients methodsIndividuals from the Toronto Lupus Clinic with at least 2 years of follow-up and no prior AVE were divided in three groups according to their mean blood pressure (BP) over that period (≥140/90 mm Hg, 130-139/80-89 mm Hg and <130/80 mm Hg). They were followed until the first occurrence of an AVE (fatal or non-fatal coronary artery disease, cerebrovascular event and peripheral vascular disease) or last visit. Groups were compared as per the baseline atherosclerotic risk factors. A multivariable time-dependent analysis was performed to adjust for the presence of other risk factors.ResultsOf 1532 patients satisfying the inclusion criteria, 155 (10.1%) had a BP ≥140/90 mm Hg, 316 (20.6%) 130–139/80–89 mm Hg and 1061 (69.3%) were normotensives. After a mean follow-up of 10.8 years, 124 AVEs were documented. The incidence rates were 18.9, 11.5 and 4.5 per 1000 patient-years for the three groups, respectively (p=0.0007 between the 130–139/80–89 mm Hg group and the normotensives). A mean BP of 130–139/80–89 mm Hg over the first 2 years was independently associated with the occurrence of AVEs (HR 1.73, 95% CI 1.13 to 2.65, p=0.011).ConclusionPatients with lupus with a sustained mean BP of 130–139/80–89 mm Hg over 2 years had a significantly higher incidence of AVEs compared with normotensive individuals. This BP level should be the target for antihypertensive therapy to minimise their cardiovascular risk.

scholarly journals Functional Polymorphisms of the Coagulation Factor II Gene (F2) and Susceptibility to Systemic Lupus Erythematosus

2011 ◽  
Vol 38 (4) ◽  
pp. 652-657 ◽  
Author(s):  
F. YESIM K. DEMIRCI ◽  
AMY S. DRESSEN ◽  
CANDACE M. KAMMERER ◽  
M. MICHAEL BARMADA ◽  
AMY H. KAO ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
African Americans ◽  
Allele Frequency ◽  
Lupus Erythematosus ◽  
Coagulation Factor ◽  
Systemic Lupus ◽  
Vascular Events ◽  
Functional Polymorphisms ◽  
Caucasian Americans ◽  
Activity Measurements

Objective.TwoF2functional polymorphisms, rs1799963 (G20210A) and rs3136516 (A19911G), are known to be associated with elevated levels/activity of prothrombin (encoded byF2) and risk of thrombosis. Since patients with systemic lupus erythematosus (SLE) have high risk of thrombosis and accelerated atherosclerosis and also high prevalence of anti-prothrombin antibodies, we hypothesized that these twoF2polymorphisms could affect risk of SLE.Methods.We investigated these polymorphisms in 627 women with SLE (84% Caucasian Americans, 16% African Americans) and 657 female controls (78% Caucasian Americans, 22% African Americans).Results.While the rs1799963 A allele was almost absent in African Americans, it was present at ∼2% frequency in Caucasian Americans and showed no significant association with SLE. The rs3136516 G allele frequency was significantly higher in Caucasian SLE cases than in controls (48.4% vs 43.7%, respectively) with a covariate-adjusted odds ratio (OR) of 1.22 (95% CI 1.03–1.46, p = 0.023). The association was replicated in African Americans (rs3136516 G allele frequency 91.2% in cases vs 82.2% in controls) with an adjusted OR of 1.96 (95% CI 1.08–3.58, p = 0.022). Stratification of Caucasian SLE patients based on the presence or absence of cardiac and vascular events (CVE) revealed stronger association with the CVE-positive SLE subgroup than the CVE-negative SLE subgroup (OR 1.42 vs 1.20). Prothrombin activity measurements in a subset of SLE cases demonstrated higher activity in the carriers of the rs3136516 G allele.Conclusion.Our results suggest a potential role for prothrombin and the crosstalk between hemostatic and immune/inflammatory systems in SLE and SLE-associated cardiovascular events, which warrants further investigation in independent samples.

scholarly journals Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXI. Disease activity, damage accrual, and vascular events in pre- and postmenopausal women

2005 ◽  
Vol 52 (6) ◽  
pp. 1655-1664 ◽  
Author(s):  
Mónica Fernández ◽  
Jaime Calvo-Alén ◽  
Graciela S. Alarcón ◽  
Jeffrey M. Roseman ◽  
Holly M. Bastian ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Postmenopausal Women ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Vascular Events ◽  
Damage Accrual

scholarly journals FRI0284 Predictors of arterial vascular events in a cohort of systemic lupus erythematosus

2017 ◽  
Author(s):  
J-G Erdozain ◽  
I Villar ◽  
J Nieto ◽  
I Ruiz-Arruza ◽  
J-I Pijoan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Vascular Events

Atherosclerotic Vascular Events in Systemic Lupus Erythematosus: An Evolving Story

2019 ◽  
Vol 47 (1) ◽  
pp. 66-71
Author(s):  
Murray B. Urowitz ◽  
Jiandong Su ◽  
Dafna D. Gladman
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Early Recognition ◽  
Systemic Lupus ◽  
Vascular Events ◽  
Cox Models ◽  
Mortality And Morbidity ◽  
University Of Toronto

Objective.Atherosclerotic vascular events (AVE) are a major cause of mortality and morbidity in systemic lupus erythematosus (SLE). We aimed to determine the effect of early recognition and therapy for both classic risk factors for AVE and for SLE, on the burden of AVE in SLE in recent decades.Methods.Inception patients who entered the University of Toronto Lupus Clinic between 1975 and 1987 followed to 1992 (Cohort 1), and between 1999 and 2011 followed to 2016 (Cohort 2) were studied. AVE attributed to atherosclerosis and occurring during the 17 years were identified. SLE disease activity and therapy as well as hypertension, hypercholesterolemia, hyperglycemia, and smoking were assessed. Analysis included descriptive statistics on baseline characteristics, traditional risk factors over the followup, outcome rates by each 100 person-years (PY), Kaplan-Meier cumulative AVE curves, as well as competing risk Cox models adjusted by inverse probability weights.Results.Of the 234 patients in Cohort 1, 26 patients (11%) had an AVE compared with 10 of 262 patients (3.8%) in Cohort 2. The rate per 100 PY of followup was 1.8 in Cohort 1 and 0.44 in Cohort 2 (p < 0.0001). Better control of all risk factors and disease activity was achieved in Cohort 2. There was a reduction of 60% in the risk for AVE in Cohort 2.Conclusion.The incidence of AVE in SLE in the modern era has declined in large part owing to more effective management of classic coronary artery risk factors and of SLE.

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