Increased Pulse Wave Velocity in Systemic Lupus Erythematosus: A Meta-Analysis

Abstract

Systemic lupus erythematosus (SLE) is associated with increased cardiovascular risk. This study aims to derive a more precise estimation on pulse wave velocity (PWV) level in patients with SLE and related factors. A literature search was performed using PubMed, EMBASE, and The Cochrane Library databases, studies published up to February 28, 2017, in English. Pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated by fixed-effect or random-effect model analysis. Heterogeneity test was performed by the Q statistic and quantified using I; publication bias was evaluated using a funnel plot and Egger's linear regression test. Of 156 studies found, 27 met eligibility criteria, and 14 studies were finally included in the meta-analysis. Meta-analysis revealed that the SLE group had significantly higher PWV levels than the control group; SMD = 0.56 and 95% CI (0.30-0.82). Subgroup analyses showed that body mass index (BMI), sample size, and disease duration were associated with PWV in patients with SLE. Overall, our study suggests that patients with SLE have a higher PWV level, and it is associated with BMI, sample size, and disease duration.

Aortic Stiffening Is an Extraintestinal Manifestation of Inflammatory Bowel Disease: Review of the Literature and Expert Panel Statement

“…32 –50,51 To date, at least 13 single-center cross-sectional studies 33 –45 and 2 multicenter longitudinal studies 37,50,51 suggest that aortic stiffness and reflected waves are increased in adult patients with CD and UC, even after adjustment for known CV risk factors (Table 1) and that the severity and duration of inflammation over time has a key role in the arterial stiffening process. These results have been confirmed in 4 aggregated data 32,46,47,48 and 1 individual participant data meta-analysis 49 performed in patients with IBD, which are in agreement with similar findings reported in patients with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and periodontitis 16 –18,53 and could suggest that arterial stiffness is a vascular biomarker of chronic inflammation. 54 Further longitudinal studies are needed to confirm this hypothesis.…”

“…13 –15 Similar findings were reported in other chronic inflammatory conditions characterized by high levels of tumor necrosis factor (TNF), such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and chronic kidney disease. 16 –19 Regarding treatment, steroids are associated with an increased risk of acute arterial events in IBD. 20 In contrast, other immunosuppressive drugs may lower the risk of acute arterial events due to their anti-inflammatory actions, as increasingly recommended in rheumatoid arthritis.…”

Subclinical Atherosclerosis in Patients With Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis

“…However, this meta-analysis reported only 1 recognized marker (cIMT) of subclinical atherosclerosis, other surrogate markers, such as flow-mediated dilation (FMD%), carotid-femoral pulse wave velocity (cf-PWV), and glyceryl trinitrate-mediated dilatation (GTN%) were not evaluated. 24,25…”

Subclinical parameters of arterial stiffness and arteriosclerosis correlate with QRISK3 in systemic lupus erythematosus

“…In contrast, other studies related increased cfPWV with SLE, low C3 complement levels and high CRP [22]. Recently, a meta-analysis of cfPWV studies in SLE patients concluded that cfPWV was increased vs CS [23]. In addition, in type 2 diabetes, it was explored the consequences of long term increased arterial stiffness on microvascular damage [24].…”