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cardiovascular events in systemic lupus

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https://www.readbyqxmd.com/read/28840094/the-risk-benefit-ratio-of-glucocorticoids-in-sle-have-things-changed-over-the-past-40-years
#1
G Stojan, M Petri
PURPOSE OF REVIEW: Glucocorticoids have been the mainstay of treatment in systemic lupus erythematosus for more than half a century. Despite advancements in knowledge concerning the pathophysiology of systemic lupus, the genomic/non-genomic actions of glucocorticoids, and the use of novel therapeutic agents in SLE, the burden of toxicity from glucocorticoid use remains unchanged. RECENT FINDINGS: SLE patients receiving long-term prednisone therapy are at significant risk of morbidity due to permanent organ damage and prednisone daily dosages above 6 mg have been shown to increase the risk of future organ damage by 50%...
September 2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/28837372/update-upon-efficacy-and-safety-of-etanercept-for-the-treatment-of-spondyloarthritis-and-juvenile-idiopathic-arthritis
#2
Giuseppe Murdaca, Simone Negrini, Ottavia Magnani, Elena Penza, Marco Pellecchio, Rossella Gulli, Paola Mandich, Francesco Puppo
TNF-α inhibitors have demonstrated efficacy both as monotherapy and in combination with disease-modifying anti-rheumatic drugs (DMARDs) in the treatment of chronic inflammatory immune-mediated diseases such as rheumatoid arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis (AS), psoriasis (Ps) and/or psoriatic arthritis (PsA) and may be administered off-label to treat disseminated granuloma annulare, systemic lupus erythematosus and systemic sclerosis. There are several TNF-α inhibitors available for clinical use including infliximab, adalimumab, golimumab, certolizumab pegol and etanercept...
August 24, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28762647/renal-histology-in-indigenous-australians-with-lupus-nephritis
#3
Farshad Ghazanfari, Zulfikar Jabbar, Johannes Nossent
BACKGROUND: Lupus nephritis (LN) is a feared complication of systemic lupus erythematosus (SLE). Renal biopsy is valuable to assess disease severity and prognosis, but no histological data are available for Indigenous Australians (IA). We compared histopathology between IA and non-IA patients (NI) with LN in northern Australia and describe main outcomes. METHODS: Retrospective cohort study of all patients with biopsy evidence of LN at Royal Darwin Hospital over a 10-year period...
August 1, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28728509/do-adverse-pregnancy-outcomes-contribute-to-accelerated-cardiovascular-events-seen-in-young-women-with-systemic-lupus-erythematosus
#4
M C Soh, C Nelson-Piercy, M Westgren, L McCowan, D Pasupathy
Cardiovascular events (CVEs) are prevalent in patients with systemic lupus erythematosus (SLE), and it is the young women who are disproportionately at risk. The risk factors for accelerated cardiovascular disease remain unclear, with multiple studies producing conflicting results. In this paper, we aim to address both traditional and SLE-specific risk factors postulated to drive the accelerated vascular disease in this cohort. We also discuss the more recent hypothesis that adverse pregnancy outcomes in the form of maternal-placental syndrome and resultant preterm delivery could potentially contribute to the CVEs seen in young women with SLE who have fewer traditional cardiovascular risk factors...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28718063/new-insights-on-platelets-and-platelet-derived-microparticles-in-systemic-lupus-erythematosus
#5
REVIEW
Marc Scherlinger, Vanja Sisirak, Christophe Richez, Estibaliz Lazaro, Pierre Duffau, Patrick Blanco
PURPOSE OF REVIEW: Current knowledge on the role of platelets and platelet-derived microparticles (PMPs) on the immune system has been fast-growing. Systemic lupus erythematosus (SLE) is a systemic auto-immune disorder characterized by a loss of tolerance toward nuclear auto-antigens. Although recent studies allowed a better understanding of SLE pathogenesis, there is an urgent need for the development of new treatments and the identification of new biomarkers to assess the disease activity...
August 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28705378/reliability-of-cardiovascular-risk-calculators-to-estimate-accurately-the-risk-of-cardiovascular-disease-in-patients-with-sarcoidosis
#6
MULTICENTER STUDY
Patompong Ungprasert, Eric L Matteson, Cynthia S Crowson
Chronic inflammation is an independent risk factor for cardiovascular disease (CVD), but most risk calculators, including the Framingham risk score (FRS) and the American College of Cardiology (ACC)/American Heart Association (AHA) risk score do not account for it. These calculators underestimate cardiovascular risk in patients with rheumatoid arthritis and systemic lupus erythematosus. To date, how these scores perform in the estimation of CVD risk in patients with sarcoidosis has not been assessed. In this study, the FRS and the ACC/AHA risk score were calculated for a previously identified cohort of patients with incident cases of sarcoidosis in Olmsted County, Minnesota, United States, from 1989 to 2013 as well as their gender- and age-matched comparators...
September 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28675998/cardiovascular-and-pulmonary-manifestations-of-systemic-lupus-erythematosus
#7
M B Urowitz, Konstantinos Tselios
BACKGROUND: Systemic lupus erythematosus (SLE) is characterized by various clinical manifestations and immunologic abnormalities. Among clinical manifestations, cardiovascular and respiratory system involvement is increasingly recognized as critical for patients' prognosis. OBJECTIVE: Heart involvement, most commonly presents with pericarditis. However, valvular disease and less often myocarditis may be detected. METHOD: Accelerated atherosclerosis is currently considered as one of the most important co-morbidities of SLE with cardiovascular events being one of the leading causes of death at relatively young ages...
July 4, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28606749/cardiovascular-disease-in-systemic-lupus-erythematosus-a-comprehensive-update
#8
REVIEW
Mayra Giannelou, Clio P Mavragani
Heightened rates of both cardiovascular (CV) events and subclinical atherosclerosis, documented by imaging and vascular function techniques are well established in systemic lupus erythematosus (SLE). While traditional CV factors such as smoking, dyslipidemia, diabetes mellitus (DM), hypertension, central obesity and hyperhomocysteinemia have been reported to be prevalent in lupus patients, they do not fully explain the high rates of ischemic events so far reported, implying that other factors inherent to disease itself could account for the enhanced risk, including disease duration, activity and chronicity, psychosocial factors, medications, genetic variants and altered immunological mechanisms...
August 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28598016/race-ethnicity-and-cardiovascular-events-among-patients-with-systemic-lupus-erythematosus
#9
Medha Barbhaiya, Candace H Feldman, Hongshu Guan, Jose A Gómez-Puerta, Michael A Fischer, Daniel H Solomon, Brendan Everett, Karen H Costenbader
OBJECTIVE: Systemic lupus erythematosus (SLE) is more prevalent and results in more severe outcomes among blacks, Asians, and Hispanics than among whites. Cardiovascular disease (CVD) is the leading cause of death among SLE patients. We undertook this study to examine racial/ethnic variations in risk of CVD events among SLE patients. METHODS: Within the Medicaid Analytic eXtract from 2000 to 2010, we identified patients ages 18-65 years with SLE (≥3 International Classification of Diseases, Ninth Revision 710...
September 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28589322/comparison-of-systemic-lupus-erythematosus-sle-patients-managed-early-after-diagnosis-in-specialty-versus-community-care-clinics
#10
Roaa Aljohani, Dafna D Gladman, Jiandong Su, Murray B Urowitz
To compare management and outcomes of SLE patients treated in community clinics (Cc) with those treated in specialty clinic (Sc) within 10 years after SLE diagnosis. A single-center, matched cohort study design was used. We identified 54 SLE patients who were referred to a Sc from Cc within 5 years of SLE diagnosis, and 101 inception SLE patients who followed in a Sc. Patients in Cc were matched 1:2 based on gender, decade of SLE diagnosis, and age at diagnosis within 3 years with Sc patients. Disease characteristics, damage accumulation, death, cardiovascular (CVS) risk factors, and events were compared at 5 and 10 years of disease...
August 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28507183/longterm-hydroxychloroquine-therapy-and-low-dose-aspirin-may-have-an-additive-effectiveness-in-the-primary-prevention-of-cardiovascular-events-in-patients-with-systemic-lupus-erythematosus
#11
Serena Fasano, Luciana Pierro, Ilenia Pantano, Michele Iudici, Gabriele Valentini
OBJECTIVE: Systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular disease (CVD). Thromboprophylaxis with low-dose aspirin (ASA) and hydroxychloroquine (HCQ) seems promising in SLE. We investigated the effects of HCQ cumulative dosages (c-HCQ) and the possible synergistic efficacy of ASA and HCQ in preventing a first CV event (CVE) in patients with SLE. METHODS: Patients consecutively admitted to our center who, at admission, satisfied the 1997 American College of Rheumatology and/or 2012 Systemic Lupus Collaborating Clinics classification criteria for SLE, and had not experienced any CVE, were enrolled...
July 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28469051/statins-for-prevention-of-cardiovascular-disease-in-systemic-lupus-erythematosus
#12
F A Yousef Yengej, M Limper, H L Leavis
OBJECTIVE: In systemic lupus erythematosus (SLE), cardiovascular disease (CVD) is an important cause of long-term morbidity, which could be affected by statin use. Here we review the evidence for the use of statins for the prevention of CVD in patients with SLE. METHODS: The PubMed database was searched using a query combining SLE and statins. RESULTS: The search yielded nine relevant clinical studies. Seven studies reported on radiological findings that correlate with atherosclerosis and mainly revealed that statin treatment resulted in a slight decrease in progression of carotid intima-media thickness and an increase in flow-mediated vasodilatation...
April 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28457197/management-of-cardiovascular-risk-in-systemic-lupus-erythematosus-a-systematic-review
#13
C Andrades, C Fuego, S Manrique-Arija, A Fernández-Nebro
Systemic lupus erythematosus is associated with accelerated atherosclerosis and increased risk of cardiovascular complications. The aim of this study was to review the effectiveness of interventions for primary and secondary prevention of cardiovascular events and mortality and to review the effectiveness of interventions for cardiovascular risk factor reduction in systemic lupus erythematosus patients. A systematic review was conducted. Electronic databases Medline and Embase (1961-2015) were searched. Nineteen articles met the inclusion criteria and were selected...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28414714/excess-atherosclerosis-in-systemic-lupus-erythematosus-a-matter-of-renal-involvement-case-control-study-of-281-sle-patients-and-281-individually-matched-population-controls
#14
Johanna T Gustafsson, Marie Herlitz Lindberg, Iva Gunnarsson, Susanne Pettersson, Kerstin Elvin, John Öhrvik, Anders Larsson, Kerstin Jensen-Urstad, Elisabet Svenungsson
BACKGROUND: Systemic lupus erythematosus (SLE), is a heterogeneous disease which predominantly affects young females (90%). SLE is associated with a shorter life expectancy than in the general population. Standardized mortality ratios (SMR) of 2.4 have been reported, which is comparable to diabetes. In modern societies cardiovascular disease (CVD) is the major cause of premature mortality. Accelerated atherosclerosis is generally assumed to be the underlying cause for SLE related CVD...
2017: PloS One
https://www.readbyqxmd.com/read/28319545/systemic-lupus-erythematosus-is-associated-with-increased-adverse-postoperative-renal-outcomes-and-mortality-a-historical-cohort-study-using-administrative-health-data
#15
Rovnat Babazade, Huseyin Oguz Yilmaz, Steve M Leung, Nicole M Zimmerman, Alparslan Turan
BACKGROUND: Systemic lupus erythematosus (SLE) is a common autoimmune connective tissue disease that mainly harms kidneys, heart, lungs, and nervous system. Effects of surgical stimulus and anesthesia combined with SLE-related pathologies may increase morbidity and mortality. Therefore, we aimed to evaluate the association between SLE (versus none) and postoperative renal, cardiac, and in-hospital mortality complications among patients undergoing major surgeries. METHODS: We obtained censuses of 2009 to 2011 inpatient hospital discharges across 7 states and conducted a retrospective cohort study by using International Classification of Diseases and Injuries, Version 9, diagnosis codes, procedure codes, and present-on-admission indicators...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28183339/prevalence-and-associated-factors-of-resting-electrocardiogram-abnormalities-among-systemic-lupus-erythematosus-patients-without-cardiovascular-disease
#16
Hanan Al Rayes, Paula J Harvey, Dafna D Gladman, Jiandong Su, Arthy Sabapathy, Murray B Urowitz, Zahi Touma
BACKGROUND: Electrocardiogram (ECG) cardiovascular disease (CVD) abnormalities (ECG-CVD) are predictive of subsequent CVD events in the general population. Systemic lupus erythematosus (SLE) patients are vulnerable to CVD. We aimed to determine the prevalence of ECG-CVD in SLE patients and to examine the risk factors associated with ECG-CVD. METHODS: A 12-lead resting supine ECG was performed on consecutive adult patients attending the clinic. One cardiologist interpreted the ECGs...
February 10, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28168661/psoriasis-in-systemic-lupus-erythematosus-a-single-center-experience
#17
Konstantinos Tselios, Kristy Su-Ying Yap, Rattapol Pakchotanon, Ari Polachek, Jiandong Su, Murray B Urowitz, Dafna D Gladman
The coexistence of psoriasis with systemic lupus erythematosus (SLE) has been reported in limited case series, raising hypotheses about shared pathogenetic mechanisms. Nevertheless, important differences regarding treatment do exist. The aim of the present study was to determine the prevalence and characteristics of psoriasis in a defined cohort of lupus patients. Patients with psoriasis were retrieved from the University of Toronto Lupus Clinic from its inception in 1970 up to 2015. Charts were hand-searched to collect information concerning demographic, clinical, and therapeutic variables...
April 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28168401/dyslipidemia-in-systemic-lupus-erythematosus
#18
Melinda Zsuzsanna Szabó, Peter Szodoray, Emese Kiss
Cardiovascular disease is one of the major causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Accelerated atherosclerosis is related to traditional (age, hypertension, diabetes mellitus, dyslipidemia, obesity, smoking, and positive family history) and non-traditional, disease-related factors. Traditional risk factors are still more prominent in patients with lupus, as both hypertension and hypercholesterinemia were independently associated with premature atherosclerosis in several SLE cohorts...
April 2017: Immunologic Research
https://www.readbyqxmd.com/read/28155616/crosstalk-between-oxidative-and-nitrosative-stress-and-arterial-stiffness
#19
Ioana Mozos, Constantin Tudor Luca
Arterial stiffness, the expression of reduced arterial elasticity, is an effective predictor of cardiovascular disorders. Oxidative stress is an imbalance between exposure to toxic reactive oxygen species (ROS) and antioxidant systems. The increase in reactive nitrogen species (RNS) is termed nitrosative stress. We review the main mechanisms and products linking arterial stiffness with oxidative and nitrosative stress in several disorders, focusing on recent experimental and clinical data, and the mechanisms explaining benefits of antioxidant therapy...
February 1, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28129475/risk-of-myocardial-infarction-and-stroke-in-newly-diagnosed-systemic-lupus-erythematosus-a-general-population-based-study
#20
J Antonio Aviña-Zubieta, Fergus To, Kateryna Vostretsova, Mary De Vera, Eric C Sayre, John M Esdaile
OBJECTIVE: To estimate the future risk and time trends of newly diagnosed myocardial infarction (MI), ischemic stroke, or both (cardiovascular disease [CVD]) in individuals with systemic lupus erythematosus (SLE). METHODS: Using a population-based database that includes all residents of British Columbia, Canada, we conducted a matched cohort study of all patients with incident SLE and up to 10 age-, sex-, and entry time-matched individuals from the general population...
June 2017: Arthritis Care & Research
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