The SLICC inception cohort for atherosclerosis

Abstract

The Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) is a group of rheumatologists and methodologists from 27 international centers who have a particular interest and expertise in systemic lupus erythematosus. Initially, its efforts focused on development and validation of disease activity and damage indices. In 2000, the SLICC Registry for Atherosclerosis was established to determine the incidence, prevalence, nature, and risk factors of atherosclerotic coronary artery disease in systemic lupus erythematosus. Risk factors for coronary artery disease at presentation to the cohort were reported, as well as their accumulation over the first few years. Development of the metabolic syndrome was also described. Among the first 1078 patients who entered the cohort, 61 vascular events have occurred in 47 patients who were older at diagnosis and more likely male and hypertensive than were the patients without vascular events. Additional studies using this cohort are ongoing.

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

“…Several studies in SLE showed that hypertension is independently associated with increased rates of AVEs with a HR ranging from 1.05 to 3.5 6 13–18. Furthermore, hypertension has been related to every surrogate end-point for atherosclerosis, including impaired endothelial function,19 20 arterial stiffness,21–23 increased carotid intima–media thickness and plaque formation,24–26 coronary artery calcification27 and angiographically proven CAD 28.…”

Cardiovascular Outcomes in Systemic Lupus Erythematosus: Big Studies for Big Questions

“…However, it remains unclear what the exact contributing factors are, and crucially, which interventions will be effective in primary or secondary prevention in SLE. Large-scale efforts such as the current study 12 and collaborative efforts such as those undertaken by SLICC (Systemic Lupus International Collaborating Clinics) 18 point the way and show that in SLE adequately powered studies are feasible. Building on these endeavors and translating current knowledge into changes in practice will be the next step.…”

Mortality in SLE

“…In the very large multicenter multinational inception SLE cohort, a project begun a decade ago by the SLICC, 31 patients who died had CAD more often at enrollment. 24 Similarly, CAD was a predictor of death (as a result of any cause) in the multivariate hazard ratio (HR) analyses of Urowitz and colleagues, 18 performed on a long-term cohort of prevalent patients with SLE.…”