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cardiovascular events in systemic lupus

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https://www.readbyqxmd.com/read/29145701/tnf-antagonists-killing-two-birds-with-one-biologic-stone
#1
EDITORIAL
Joan M Bathon, Jon T Giles, Daniel H Solomon
Forty years have passed since it was first recognized that patients with autoimmune rheumatic disease have an increased risk of fatal and non-fatal cardiovascular (CV) events (1) Although initial reports focused on rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), similar findings were verified subsequently in patients with psoriasis (Ps) and/or psoriatic arthritis (PsA) and spondyloarthritis. An early feature of the atherosclerotic lesion is infiltration with inflammatory cells, particularly monocytes/macrophages, and the presence of these cells in mature plaque elevates the risk of plaque rupture and thrombosis (2)...
November 16, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29142034/cumulative-burden-of-glucocorticoid-related-adverse-events-in-patients-with-systemic-lupus-erythematosus-findings-from-a-12-year-longitudinal-study
#2
Hung-Lin Chen, Li-Jiuan Shen, Ping-Ning Hsu, Chieh-Yu Shen, Susan A Hall, Fei-Yuan Hsiao
OBJECTIVE: The aim of this population-based study is to examine the adverse events (AE) associated with longitudinal systemic glucocorticoid (GC) use among an ethnic Chinese systemic lupus erythematosus (SLE) cohort. METHODS: Our study subjects were patients with newly diagnosed SLE aged 18 and older who received at least 1 prescription of systemic GC between 2001 and 2012 from Taiwan's National Health Insurance Research Database (NHIRD). The earliest prescription date of systemic GC for each subject was defined as the index date...
November 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29094181/cardiovascular-disease-in-patients-with-autoinflammatory-syndromes
#3
REVIEW
Rainer Hintenberger, Agnes Falkinger, Kathrin Danninger, Herwig Pieringer
Autoinflammatory syndromes (AIS) are characterized by recurring events of inflammation, leading to a variety of organ manifestations and fever attacks. A subgroup of AIS is commonly referred to as hereditary periodic fever syndromes (HPFS). There is substantial evidence that autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus are strongly associated with cardiovascular morbidity and mortality. The link between AIS and cardiovascular disease is not that clear, even if the concept of continuous inflammation as a risk factor for cardiovascular disease is widely accepted...
November 1, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29093154/evolution-of-risk-factors-for-atherosclerotic-cardiovascular-events-in-systemic-lupus-erythematosus-a-longterm-prospective-study
#4
Konstantinos Tselios, Dafna D Gladman, Jiandong Su, Olga Ace, Murray B Urowitz
OBJECTIVE: We previously reported the effect of certain factors on cardiovascular disease (CVD) in 250 women with systemic lupus erythematosus (SLE) followed for 8 years. The aim of this study was to delineate their evolution after 15 years of followup. METHODS: There were 210 women with SLE and 138 age-matched healthy women available for analysis after 15 years. Cardiovascular events (CVE) included angina pectoris, myocardial infarction (fatal and nonfatal), transient ischemic attack, and stroke (fatal and nonfatal)...
November 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29038899/the-use-of-primary-prevention-statin-therapy-in-those-predisposed-to-atherosclerosis
#5
REVIEW
Michael Garshick, James A Underberg
PURPOSE OF REVIEW: Many guidelines exist for the use of statins in the primary prevention of atherosclerotic cardiovascular disease (ASCVD). Few have focused on disease specific states that predispose to ASCVD. This review is intended to focus on the recommendations and evidence in inflammatory diseases that predispose to an increased risk of ASCVD beyond what conventional cardiac risk scores would predict. RECENT FINDINGS: Certain autoimmune inflammatory diseases such as rheumatoid arthritis (RA), systemic lupus erythematous (SLE), and psoriasis/psoriatic arthritis have all been shown to increase the risk of ASCVD...
October 17, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28993952/discordance-of-the-framingham-cardiovascular-risk-score-and-the-2013-american-college-of-cardiology-american-heart-association-risk-score-in-systemic-lupus-erythematosus-and-rheumatoid-arthritis
#6
Kashif Jafri, Alexis Ogdie, Atif Qasim, Sarah L Patterson, Milena Gianfrancesco, Zara Izadi, Patricia Katz, Jinoos Yazdany, Gabriela Schmajuk
Despite the increasing use of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cardiovascular (CV) risk score in clinical practice, few studies have compared this score to the Framingham risk score among rheumatologic patients. We calculated Framingham and 2013 ACC/AHA risk scores in subjects with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and assessed demographic, CV, and rheumatologic characteristics associated with discordant scores (high-risk ACC/AHA scores but low-risk Framingham scores)...
October 9, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28974909/age-adjusted-charlson-comorbidity-index-scores-predict-major-adverse-cardiovascular-events-and-all-cause-mortality-among-systemic-lupus-erythematosus-patients
#7
Mei-Hua Chuang, Tzyy-Ling Chuang, Kuang-Yung Huang, Yuh-Feng Wang
OBJECTIVE: Cardiovascular events are the most frequent cause of death or disability among people with systemic lupus erythematosus (SLE). However, the causes of this increased the risk of major adverse cardiovascular events (MACEs) are not completely understood. The Age-adjusted Charlson Comorbidity Index (ACCI) is a prognostic classification that was initially developed for patients who have a number of comorbid conditions and the ACCI has been validated in many clinical settings. MATERIALS AND METHODS: In this study, 5998 patients were enrolled from the National Health Research Institute Database of Taiwan...
July 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28840094/the-risk-benefit-ratio-of-glucocorticoids-in-sle-have-things-changed-over-the-past-40-years
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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