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cardiovascular events in systemic lupus

Marie-Louise Hermansen, Jesper Lindhardsen, Christian Torp-Pedersen, Mikkel Faurschou, Søren Jacobsen
OBJECTIVE: To assess the role of LN as a risk factor for myocardial infarction (MI), stroke and cardiovascular mortality (CVM) in patients with SLE. METHODS: The study was conducted using individual-level data from multiple nationwide registers. We identified a cohort of patients diagnosed with SLE and further determined if they had a diagnosis of LN during 1995-2011. Each SLE patient was matched with five population controls. Hazard ratios (HRs) were calculated to measure the risk of MI, stroke and CVM in SLE patients relative to population controls and in SLE patients with relative to without LN...
January 3, 2017: Rheumatology
Otto Hartman, Petri T Kovanen, Jukka Lehtonen, Kari K Eklund, Juha Sinisalo
BACKGROUND: Inflammation of the arterial wall plays a central role in the pathogenesis of atherosclerosis. Among patients with rheumatic diseases, anti-rheumatic medication reduces the incidence of cardiovascular (CV) diseases, but only few studies have addressed their cardioprotective effects on patients with no rheumatic diseases. Hydroxychloroquine (HCQ) is an anti-rheumatic drug commonly used in the treatment of rheumatoid arthritis and systemic lupus erythematosus. In addition to its anti-inflammatory properties, HCQ reduces cholesterol levels and the risk of type II diabetes, and has also anti-platelet effects...
November 8, 2016: European Heart Journal. Cardiovascular Pharmacotherapy
Pavel Kraml
Oxidation of atherogenic low-density lipoproteins (LDL) plays a key role in the pathogenesis of atherosclerosis. Oxidation stress and inflammation are closely interrelated and they can potentiate one another. In the subendothelial space of the arterial intima, monocytes/macrophages become activated and phagocyte oxidized LDL (oxLDL) via scavenger receptors. It has been demonstrated that oxLDL forms complex with plasma β2-glycoprotein I (β2GPI) and becomes autoantigenic triggering synthesis of specific antiphosholipid antibodies...
2016: Vnitr̆ní Lékar̆ství
Biji Theyilamannil Kurien, James Fesmire, Camille Jean Anderson, Robert Hal Scofield
BACKGROUND: Premature atherosclerosis is observed in systemic lupus erythematosus (SLE). Oxidative modification of LDL is associated with atherosclerotic plaque formation. OBJECTIVES: We hypothesized that anti-oxidized LDL (oxLDL) and anti-phospholipid (APL) in SLE sera would segregate with specific antibody subsets, and that anti-oxLDL antibodies will linger in circulation over an extended period. PATIENTS AND METHODS: Sixty-seven SLE and control subjects and two SLE subjects with sera collected longitudinally for 13 years were tested for anti-oxLDL and IgG/IgM/IgA APL antibodies...
December 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Elsy Aidé García-Villegas, Horacio Márquez-González, Luis Felipe Flores-Suárez, Antonio Rafael Villa-Romero
BACKGROUND: Patients with systemic lupus erythematosus (SLE) have 3times the risk of death compared to the rest of the population, with cardiovascular events (CVD) being one of the main causes. Índices such as waist-height (W-Ht I), waist-hip (W-Hp I) and pulse-mass (PMI) predict CVD, though the behaviour is unknown in patients with SLE. The aim of this study was to determine the prognostic value of PMI in the development of CVD in premenopausal women with SLE. METHODOLOGY: Cohort study...
January 20, 2017: Medicina Clínica
A A Ngaïdé, F Ly, K Ly, M Diao, Ad Kane, A Mbaye, M Lèye, F Aw, S A Sarr, M Dioum, C T Ndao, N D Gaye, M B Ndiaye, M Bodian, M B Bah, M Ndiaye, A F Cissé, I Kouamé, A Tabane, J S Mingou, P Thiombiano, A Kane, S A Bâ
Systemic lupus erythematosus is a non-specific inflammatory disorder of an organ of unknown cause and autoimmune origin. Visceral injuries, including those cardiovascular, determine the prognosis of this disease primarily affecting women. The objectives of this study were to determine the frequency and describe the cardiovascular manifestations in systemic lupus erythematosus in a lupus population of the Dakar region. This is a multicenter prospective study descriptive and analytical conducted in the region of Dakar (Senegal) from 14 February 2011 to 2 July 2012...
December 2016: Bulletin de la Société de Pathologie Exotique
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 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 2 large cohorts of patients with primary Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE), with a focus on cardiovascular (CV) diseases. METHODS: This was a cross-sectional multicenter study where the prevalence of more relevant comorbidities in 2 cohorts was compared. Patients under followup from SJOGRENSER (Spanish Rheumatology Society Registry of Primary SS) and RELESSER (Spanish Rheumatology Society Registry of SLE), and who fulfilled the 2002 American-European Consensus Group and 1997 American College of Rheumatology classification criteria, respectively, were included...
January 2017: 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
OBJECTIVE: Cardiovascular disease (CVD) has been recognized as a major cause of morbidity in patients with systemic lupus erythematosus (SLE), but it is not clear whether increased awareness of these risks has translated into improvements in CVD morbidity at the population level. The aim of this study was to examine trends in hospitalization rates for CVD events in a representative sample of adult patients with SLE in the US from 1996 to 2012. METHODS: We used the Nationwide Inpatient Sample to estimate the rates of hospitalization for acute myocardial infarction (MI), unstable angina, and ischemic stroke from 1996 to 2012 in patients with SLE...
November 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...
January 2017: 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
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