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cardiovascular events in systemic lupus

Julie A Birt, YingMeei Tan, Neelufar Mozaffarian
OBJECTIVES: To better understand the real-world characteristics and costs of Sjögren's syndrome (SS). METHODS: Analysing the MarketScan Commercial Claims database from Jan. 1, 2006 to Dec. 31, 2011, we identified 10,414 patients ≥18 years old newly diagnosed with SS. Patient characteristics, drugs (commonly used for SS), resource utilisation, and medical costs were evaluated for 12 months pre- and post-diagnosis. RESULTS: Mean age was 55 years; 90% were female...
October 7, 2016: Clinical and Experimental Rheumatology
Iñigo Rúa-Figueroa, Mónica Fernández de Castro, José L Andreu, Carlos Sanchez-Piedra, Víctor Martínez-Taboada, Alejandro Olivé, Javier López-Longo, José Rosas, María Galindo, Jaime Calvo-Alén, Antonio Fernández-Nebro, Fernando Alonso, Beatriz Rodríguez-Lozano, Jesús Alberto García Vadillo, Raúl Menor, Francisco Javier Narváez, Celia Erausquin, Ángel García-Aparicio, Eva Tomero, Sara Manrique-Arija, Loreto Horcada, Esther Uriarte, Susana Gil, Ricardo Blanco, Ruth López-González, Alina Boteanu, Mercedes Freire, Carlos Galisteo, Manuel Rodríguez-Gómez, Elvira Díez-Álvarez, José M Pego-Reigosa
OBJECTIVE: To compare the prevalence of the main comorbidities in two large cohorts of patients with Primary Sjögren's Syndrome (pSS) and Systemic Lupus Erythematosus (SLE), with focus on cardiovascular (CV) diseases. METHODS: Cross-sectional multicenter study where the prevalence of more relevant comorbidities in two cohorts was compared. Patients under follow-up from the SJOGRENSER (Spanish Rheumatology Society Register of pSS) and RELESSER (Spanish Rheumatology Society Register of SLE) registries, and who fulfilled the 2002-AECG and 1997-ACR classification criteria, respectively, were included...
August 26, 2016: Arthritis Care & Research
R Castejon, A Castañeda, A Sollet, S Mellor-Pita, P Tutor-Ureta, C Jimenez-Ortiz, M Yebra-Bango
OBJECTIVES: Statins have been proposed as a potential treatment for systemic lupus erythematosus (SLE) due to their immunomodulatory properties, their role restoring endothelial function and preventing atherosclerosis. We evaluate the effect of a short period treatment with a low dose of atorvastatin and its withdrawal on early stage subclinical atherosclerosis. METHODS: Thirty-seven SLE females received 20 mg/day atorvastatin during eight weeks. At baseline, at the end of treatment and six months after atorvastatin withdrawal, disease activity, subclinical atherosclerosis -assessed by measuring carotid-femoral pulse wave velocity (PWV) - and quantification of circulating endothelial progenitor cells (EPC) - as a surrogate biological marker of subclinical atherosclerosis - were carried out...
August 9, 2016: Lupus
M Morreale, G Mule', C Cusumano, F D'Ignoto, V Cacciatore, G Geraci, S Cottone
OBJECTIVE: It is well known that kidney is frequently involved in patients with Systemic Lupus Erythematosus (SLE) However, conflicting data exist about the impact of renal involvement on vascular damage in this group of patients. The aim of this study was to evaluate the influence of renal damage on assessed by aortic pulse wave velocity (aPWV), evaluated a by intima-media thickness (IMT) measurement and assessed by renal resistive index (RRI) measurement, in patients with SLE. DESIGN AND METHOD: We enrolled 52 SLE subjects (mean age 39 ± 12 years), divided in two subgroups according to ACR/SLICC classification: patients with lupus nephritis, (LNG), and individuals presenting other features of SLE (Non Lupus Nephritis group, NLNG), compared to 20 age and sex matched healthy subjects...
September 2016: Journal of Hypertension
Antonios Psarras, Stergios Soulaidopoulos, Alexandros Garyfallos, George Kitas, Theodoros Dimitroulas
Systemic Sclerosis (SSc) is an autoimmune disorder characterized by microvascular injury and diffuse fibrosis of the skin and internal organs. While macrovascular disease and higher risk for cardiovascular events are well documented in other systemic rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus, the presence and extent of atherosclerosis among patients with SSc is yet to be established. Primary cardiac involvement, due to impairment of coronary microvascular circulation and myocardial fibrosis, considerably affects prognosis and life expectancy of individuals with SSc, representing one of the leading causes of death in this population...
July 12, 2016: Rheumatology International
(no author information available yet)
[This corrects the article DOI: 10.1136/lupus-2015-000143.].
2016: Lupus Science & Medicine
Maria G Tektonidou, Zhong Wang, Michael M Ward
OBJECTIVES: Cardiovascular disease (CVD) has been recognized as a major cause of morbidity in patients with systemic lupus erythematosus (SLE), but it is not clear if increased awareness of these risks has translated into improvements in CVD morbidity at the population level. To determine this, we examined national trends in rates of hospitalizations for CVD events in patients with SLE from 1996 to 2012. METHODS: We used the Nationwide Inpatient Sample to estimate rates of hospitalizations for acute myocardial infarction, unstable angina, and ischemic stroke from 1996 to 2012 in patients with SLE...
June 6, 2016: Arthritis & Rheumatology
Michele Iudici, Serena Fasano, Luisa Gabriele Falcone, Ilenia Pantano, Giovanni La Montagna, Sergio Migliaresi, Gabriele Valentini
OBJECTIVES: Cardiovascular (CV) morbidity and mortality are significantly greater in SLE patients than in the general population. ASA is known to be associated with a decrease in the incidence of CV events in high-risk patients from the general population, but its efficacy as primary prophylaxis in SLE patients has not yet been investigated. METHODS: The clinical charts of SLE patients consecutively admitted to a tertiary centre who, at admission, satisfied 1992 ACR and/or 2012 SLICC classification criteria for SLE and had not experienced any CV event, were reviewed...
September 2016: Rheumatology
J Halskou Hesselvig, O Ahlehoff, L Dreyer, G Gislason, K Kofoed
Systemic lupus erythematosus (SLE) is a well-known cardiovascular risk factor. Less is known about cutaneous lupus erythematosus (CLE) and the risk of developing cardiovascular disease (CVD). Therefore, we investigated the risk of mortality and adverse cardiovascular events in patients diagnosed with SLE and CLE. We conducted a cohort study of the entire Danish population aged ≥ 18 and ≤ 100 years, followed from 1997 to 2011 by individual-level linkage of nationwide registries. Multivariable adjusted Cox regression models were used to estimate the hazard ratios (HRs) for a composite cardiovascular endpoint and all-cause mortality, for patients with SLE and CLE...
May 27, 2016: Lupus
R Aguiar, C Araújo, G Martins-Coelho, D Isenberg
OBJECTIVES: To describe the clinical outcome and safety of rituximab (RTX) treatment in systemic lupus erythematosus (SLE) patients with severe manifestations or refractory to standard immunosuppressive therapy, treated at a single center. METHODS: This was a retrospective analysis of all patients with SLE treated with RTX at one center between June 2000 and December 2013. The clinical outcome was assessed by determining BILAG scores, anti dsDNA and C3 levels before and six months after RTX treatment...
April 25, 2016: Arthritis Care & Research
M B Urowitz, D D Gladman, N M Anderson, J Su, J Romero-Diaz, S C Bae, P R Fortin, J Sanchez-Guerrero, A Clarke, S Bernatsky, C Gordon, J G Hanly, D J Wallace, D Isenberg, A Rahman, J Merrill, E Ginzler, G S Alarcón, B F Fessler, M Petri, I N Bruce, M Khamashta, C Aranow, M Dooley, S Manzi, R Ramsey-Goldman, G Sturfelt, O Nived, K Steinsson, A Zoma, G Ruiz-Irastorza, S Lim, K C Kalunian, M Ỉnanç, R van Vollenhoven, M Ramos-Casals, D L Kamen, S Jacobsen, C Peschken, A Askanase, T Stoll
OBJECTIVE: To describe the frequency of myocardial infarction (MI) prior to the diagnosis of systemic lupus erythematosus (SLE) and within the first 2 years of follow-up. METHODS: The systemic lupus international collaborating clinics (SLICC) atherosclerosis inception cohort enters patients within 15 months of SLE diagnosis. MIs were reported and attributed on a specialised vascular event form. MIs were confirmed by one or more of the following: abnormal ECG, typical or atypical symptoms with ECG abnormalities and elevated enzymes (≥2 times upper limit of normal), or abnormal stress test, echocardiogram, nuclear scan or angiogram...
2016: Lupus Science & Medicine
Ricardo Rivera-López, Juan Jiménez-Jáimez, José Mario Sabio, Mónica Zamora-Pasadas, José Antonio Vargas-Hitos, Josefina Martínez-Bordonado, Nuria Navarrete-Navarrete, Ricardo Rivera Fernández, E Sanchez-Cantalejo, Juan Jiménez-Alonso
INTRODUCTION AND OBJECTIVES: The QT interval on the electrocardiogram has been shown to be longer in patients with systemic lupus erythematosus (SLE) compared to that of the general population. The clinical significance of this finding is unknown. The aim of this study was to assess the relationship between QT interval and subclinical atherosclerosis, measured by carotid-femoral pulse-wave velocity. MATERIAL AND METHODS: 93 patients with SLE and 109 healthy women with similar basal characteristics were studied...
2016: PloS One
Julianne R Lauring, Erik B Lehman, Timothy A Deimling, Richard S Legro, Cynthia H Chuang
BACKGROUND: The Centers for Disease Control and Prevention's US Medical Eligibility Criteria for Contraceptive Use recommends that combined hormonal contraceptives (ie, birth control pills, contraceptive patch, vaginal ring) should be avoided in women with specific medical conditions because of the increased risk of cardiovascular events associated with estrogen use. Whether women with category 3 (theoretical or proven risk usually outweigh the advantages) or category 4 (unacceptable health risk) contraindications are appropriately avoiding estrogen-containing combined hormonal contraceptives is unknown...
September 2016: American Journal of Obstetrics and Gynecology
May Ching Soh, Fadia Dib, Catherine Nelson-Piercy, Magnus Westgren, Lesley McCowan, Dharmintra Pasupathy
OBJECTIVES: Women with SLE are at increased risk of cardiovascular events (CVEs), but a relationship with traditional cardiovascular and SLE-specific risk factors has not been established. In unselected populations, adverse pregnancy outcomes linked to maternal-placental syndrome (MPS) are associated with an increased risk of CVEs. However, the effect of MPS on CVEs is unknown in women with SLE. The aim of this study was to determine if MPS increased the risk and accelerated the development of CVEs in women with SLE...
July 2016: Rheumatology
Pravesh Kumar Bundhun, Kamini Devi Boodhoo, Man-Yun Long, Meng-Hua Chen
Antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) are 2 rare autoimmune disorders which commonly affect women. Several previous studies showed APS to have been evolved from SLE. Secondary APS often coexists with SLE. One common feature relating these 2 diseases are the antiphospholipid antibodies, which are found in most of the patients with APS and in approximately 30% to 40% of patients with SLE, among which, about 10% develop APS. The leading cause of death in these patients is from cardiovascular disease due to accelerated atherosclerosis, which often progresses more rapidly, compared with the general population...
March 2016: Medicine (Baltimore)
B Hodkinson, M A Makda
Outcomes for patients with systemic lupus erythematosus (SLE) have improved during the last two decades as our understanding of the disease expands. In particular, the importance of antimalarial therapy for addressing and preventing a host of complications in SLE has emerged. Furthermore, evidence is mounting that corticosteroids, while offering excellent control of disease activity, are responsible for many of the late complications of SLE and need to be prescribed in modest doses for the shortest time possible...
December 2015: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Alessia Faccini, Juan Carlos Kaski, Paolo G Camici
Chronic inflammatory rheumatoid diseases (CIRD) such as rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis are an important risk factor for the development of ischaemic heart disease and a source of high cardiovascular morbidity and mortality. In patients affected by CIRD, inflammation can affect coronary microvascular function and contribute to the development of myocardial ischemia and cardiovascular events, even in the absence of obstructive epicardial coronary artery disease. Understanding the molecular aspects that underlie the development of coronary microvascular dysfunction (CMD) in CIRD is of fundamental importance to identify specific therapeutic targets...
June 14, 2016: European Heart Journal
Sophie I Mavrogeni, George Poulos, Petros P Sfikakis, George D Kitas, Genovefa Kolovou, George Theodorakis
Rhythm disturbances and sudden cardiac death (SCD) are important manifestations of cardiac involvement in systemic inflammatory diseases (SID). The commonest events demanding the implantation of a device include ventricular tachycardia and atrioventricular block, mainly diagnosed in sarcoidosis, systemic lupus erythematosus and scleroderma. In SCD, cardiac magnetic resonance (CMR) identified areas of late gadolinium enhancement (LGE) in 71% and provided an arrhythmic substrate in 76%, while during the follow-up, the extent of LGE identified a subgroup at increased risk for future adverse events...
June 2016: Expert Review of Cardiovascular Therapy
Konstantinos Tselios, Dafna D Gladman, Jiandong Su, Murray B Urowitz
OBJECTIVE: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are used as an adjuvant treatment in lupus nephritis (LN) patients with proteinuria. The primary aim of this study was to discover whether ACE inhibitors/ARBs have an atheroprotective effect similar to other, at-risk, populations. METHODS: A total of 144 patients (cases; mean ± SD age at onset 34 ± 12.1 years, followup 14.9 ± 8.6 years) with LN who were treated with ACE inhibitors/ARBs for at least 5 years were enrolled...
October 2016: Arthritis Care & Research
Andrea Hinojosa-Azaola, Juanita Romero-Diaz, Angel Gabriel Vargas-Ruiz, Carlos A Nuñez-Alvarez, Alba Cicero-Casarrubias, Mario C Ocampo-Torres, Jorge Sanchez-Guerrero
OBJECTIVE: The incidence of thrombosis in patients with systemic lupus erythematosus (SLE) is 25 to 50-fold higher than in the general population; we aimed to define the characteristics of venous thrombotic events (VTE) and arterial thrombotic events (ATE) to identify the patients at highest risk. METHODS: The study included 219 patients with recent-onset SLE. At baseline, standardized medical history and laboratory tests were done. Followup visits occurred quarterly, and information about damage accrual, comorbidities, and cardiovascular risk factors was updated annually...
March 2016: Journal of Rheumatology
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