SLE mortality remains disproportionately high, despite improvements over the last decade

Singh, Ram Raj; Yen, Eric Y

doi:10.1177/0961203318786436

Cited by 68 publications

(47 citation statements)

References 20 publications

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“…Atherosclerosis is an inflammatory condition, characterised by the presence of immune competent cells producing cytokines and apoptotic cells in the lesions 4. The excess cardiovascular (CV) risk in patients with SLE is well recognised 5–7. CV events are the leading cause of morbidity and mortality in SLE and prevention of progression of atherosclerosis to clinically manifest atherosclerosis is an important task.…”

Section: Introductionmentioning

confidence: 99%

Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients

et al. 2020

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ObjectiveTo compare progression of subclinical atherosclerosis and factors promoting it in patients with SLE and controls.MethodsConsecutive patients with SLE and age-matched, sex-matched population controls from the SLEVIC cohort were assessed at inclusion and after 7 years with standardised data collection and carotid ultrasound. Effect of risk factors on carotid intima–media thickness (cIMT) progression was examined with adjusted linear mixed models.ResultsA total of 77 patients and 74 controls, 68% and 61% of the original cohort, completed follow-up. The patients were (mean) 47 years old, 90% were women, and controls were 51 years old, 92% women. Patients had disease duration of (mean) 11 years, mild disease activity and low severity at both assessments. Baseline cIMT did not differ between the groups. An average absolute cIMT progression was 0.009 mm/year in patients and 0.011 mm/year in controls, intergroup difference p=0.9.Of factors at inclusion, dyslipidaemia, lower levels of high-density lipoprotein (HDL) and carotid plaque in patients and controls, and higher systolic blood pressure, total cholesterol:HDL and LDL:HDL ratios and triglycerides in patients were associated with cIMT progression. Of factors at follow-up, hypertension and blood lipids in patients and HDL in controls were significantly associated with cIMT progression. History of lupus nephritis and a higher average dose of prednisolone used since diagnosis were associated with cIMT progression in patients. Associations of risk factors with cIMT progression were stronger in presence of plaques.ConclusionWe observed a statistically comparable progression of cIMT in patients with mild SLE and controls over 7 years, which implies that progression of subclinical atherosclerosis in some patients with SLE could follow that of the general population. Traditional cardiovascular (CV) risk factors, history of lupus nephritis and higher use of corticosteroids promote cIMT progression in SLE. Detection of carotid plaque may add to CV risk stratification.

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Section: Introductionmentioning

confidence: 99%

Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients

et al. 2020

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“…The worse survival seen in AAN was not surprising given the fact that age and severity of renal disease are associated with worse prognosis in both SLE and AAV [19,230,255]. Mean age at diagnosis was 65.5 years (SD ±13.9) in patients with AAN and 38.6 years (SD ±15.1) in patients with LN.…”

Section: Survivalmentioning

confidence: 99%

The Importance of Demographic and Geographical Factors on the Incidence and Outcome of Systemic Small Vessel Vasculitis Associated with Anti-Neutrophil Cytoplasmic Antibodies

Weiner

2019

Linköping University Medical Dissertations

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The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) comprise microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA). Two serotypes are recognized: myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA. Renal involvement is a common and severe manifestation associated with increased mortality. The incidence varies geographically, but studies are difficult to compare due to heterogeneous methodology and inclusion criteria. AAV is commonly found in the elderly, but there are little data on outcome and optimal treatment in the highest age groups. This thesis focuses on the epidemiology of AAV: incidence, geographical distribution, and outcome. VDI Vasculitis Damage Index WBC white blood cell count WG Wegener's granulomatosis Table 1. ACR criteria for WG Criterion Definition Nasal or oral inflammation

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“…Despite the improvement in outcome, patients with SLE still have mortality rates two to five times higher than the general population …”

Section: Immunologymentioning

confidence: 99%

Systemic lupus erythematosus: causes and manifestations

Barcia‐Sixto

Isenberg

2020

Trends Urol & Men's Health

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SLE mortality remains disproportionately high, despite improvements over the last decade

Cited by 68 publications

References 20 publications

Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients

Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients

The Importance of Demographic and Geographical Factors on the Incidence and Outcome of Systemic Small Vessel Vasculitis Associated with Anti-Neutrophil Cytoplasmic Antibodies

Systemic lupus erythematosus: causes and manifestations

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