Background: Cardiovascular disease represents an important cause of morbidity and mortality in patients with a diagnosis of systemic lupus erythematosus (SLE), due to a complex interplay between traditional risk factors and disregulation of autoimmunity, but uncertainty is still present about the most important predictors of cardiovascular events. Objectives: Aim of our work is therefore to perform a collaborative systematic review on incidence and predictors of cardiovascular events in SLE patients. Methods: PubMed, Cochrane was systematically searched for eligible studies on SLE and cardiovascular events between January 2008 and December 2012. Study features, patient characteristics, and incidence of stent thrombosis were abstracted and pooled, when appropriate, with random-effect methods (point estimate [95% confidence intervals]),and consistency of predictors was formally appraised. Results: A total of 17187 patients were included; of those, 93.1% were female, and the median age was of 39 years. After a median follow-up period of 8 years, cardiovascular events presented in 25.4%, including acute myocardial infarction (4.1%) and stroke (7.3%). The most important predictors may be divided in traditional risk factors, like male gender (OR 6.2, CI 95% 1.49 - 25), hyperlipaemia (OR 3.9, CI 95% 1.57 – 9.71), familiar history of cardiac disease (OR 3.6, CI 95% 1.15 – 11.32) and hypertension (OR 3.5, CI 95% 1.65 – 7.54),and SLE-related features, like the presence of auto-antibodies (OR 5.8 and 5.0, CI 95% 3.28 – 7.78) and neurological disorders (OR 5.2, CI 95% 2.0 – 13.9). A low correlation was shown for importance of organ damage and SLE activity (respectively OR 1.4, CI 95% 1.09 – 4.44 and OR 1.2, CI 95% 1.2 – 1.2), as well as for the age at diagnosis (OR 1.1, CI 95% 1.07 – 1.17). Conclusions: Cardiovascular events in SLE patients are caused by a multifactorial mechanism, including both traditional and disease-specific risk factors. A global valuation with an individual risk-stratification based on both these features is important to correctly manage these patients in order to reduce negative outcomes.

Incidence and predictors of cardiovascular events in patients with systemic lupus erythematosus (SLE): a systematic review and meta-analysis / F. Ballocca; F. D'ascenzo; C. Moretti; P. Omede; E. Cerrato; U. Barbero; A. Abbate; G. Biondi Zoccai; F. Gaita. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - STAMPA. - 35 ( Abstract Supplement )(2014), pp. 992-993. ((Intervento presentato al convegno Esc Congress 2014 tenutosi a Barcellona nel 30/08/14-03/09/14.

Incidence and predictors of cardiovascular events in patients with systemic lupus erythematosus (SLE): a systematic review and meta-analysis

BALLOCCA, Flavia;D'ASCENZO, FABRIZIO;BARBERO, Umberto;GAITA, Fiorenzo
2014

Abstract

Background: Cardiovascular disease represents an important cause of morbidity and mortality in patients with a diagnosis of systemic lupus erythematosus (SLE), due to a complex interplay between traditional risk factors and disregulation of autoimmunity, but uncertainty is still present about the most important predictors of cardiovascular events. Objectives: Aim of our work is therefore to perform a collaborative systematic review on incidence and predictors of cardiovascular events in SLE patients. Methods: PubMed, Cochrane was systematically searched for eligible studies on SLE and cardiovascular events between January 2008 and December 2012. Study features, patient characteristics, and incidence of stent thrombosis were abstracted and pooled, when appropriate, with random-effect methods (point estimate [95% confidence intervals]),and consistency of predictors was formally appraised. Results: A total of 17187 patients were included; of those, 93.1% were female, and the median age was of 39 years. After a median follow-up period of 8 years, cardiovascular events presented in 25.4%, including acute myocardial infarction (4.1%) and stroke (7.3%). The most important predictors may be divided in traditional risk factors, like male gender (OR 6.2, CI 95% 1.49 - 25), hyperlipaemia (OR 3.9, CI 95% 1.57 – 9.71), familiar history of cardiac disease (OR 3.6, CI 95% 1.15 – 11.32) and hypertension (OR 3.5, CI 95% 1.65 – 7.54),and SLE-related features, like the presence of auto-antibodies (OR 5.8 and 5.0, CI 95% 3.28 – 7.78) and neurological disorders (OR 5.2, CI 95% 2.0 – 13.9). A low correlation was shown for importance of organ damage and SLE activity (respectively OR 1.4, CI 95% 1.09 – 4.44 and OR 1.2, CI 95% 1.2 – 1.2), as well as for the age at diagnosis (OR 1.1, CI 95% 1.07 – 1.17). Conclusions: Cardiovascular events in SLE patients are caused by a multifactorial mechanism, including both traditional and disease-specific risk factors. A global valuation with an individual risk-stratification based on both these features is important to correctly manage these patients in order to reduce negative outcomes.
Esc Congress 2014
Barcellona
30/08/14-03/09/14
35 ( Abstract Supplement )
992
993
http://spo.escardio.org/abstract-book/presentation.aspx?id=128308
F. Ballocca; F. D'ascenzo; C. Moretti; P. Omede; E. Cerrato; U. Barbero; A. Abbate; G. Biondi Zoccai; F. Gaita
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/158555
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