S-H Wang1, Y-S Chang1, C-J Liu2, C-C Lai3, T-J Chen4, W-S Chen5. 1. Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Medical University Shuang Ho Hospital, Taiwan National Yang-Ming University, School of Medicine, Taipei, Taiwan. 2. National Yang-Ming University, School of Medicine, Taipei, Taiwan Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan. 3. National Yang-Ming University, School of Medicine, Taipei, Taiwan Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taiwan. 4. National Yang-Ming University, School of Medicine, Taipei, Taiwan Department of Family Medicine, Taipei Veterans General Hospital, Taiwan. 5. National Yang-Ming University, School of Medicine, Taipei, Taiwan Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taiwan Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan wschen2@vghtpe.gov.tw.
Abstract
OBJECTIVE: The objective of our study was to determine the incidence rates and risk factors of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus (SLE) using a nationwide population-based data set. METHODS: We conducted a retrospective cohort study using data from the Taiwan National Health Insurance database. Patients with SLE and age-, sex- and comorbidity-matched control patients without SLE were identified. The primary endpoint was the first occurrence of aortic aneurysm or aortic dissection. The incidence rate ratios (IRRs) were calculated based on a 95% confidence interval (CI). A Cox proportional-hazards model was used to evaluate the risk factors for aortic aneurysm and aortic dissection in the SLE cohort. RESULTS: Among the 15,209 patients with SLE (89.9% women and mean age of 38.3 years), 20 developed aortic aneurysm and 13 developed aortic dissection (overall incidence rate, 4.26 per 10,000 person-years). Compared with the control patients, the overall IRR for developing aortic aneurysm or aortic dissection was 3.34 (95% CI, 1.71-6.91; p < 0.001). The IRRs for aortic aneurysm or aortic dissection were 2.98 (95% CI, 1.41-6.70, p = 0.018) for women and 5.50 (95% CI, 1.10-53.15, p = 0.020) for men. Multivariate Cox regression analysis showed that age, male sex, an SLE diagnosis greater than three years prior and hypertension were associated with aortic aneurysm and aortic dissection. CONCLUSION: Aortic aneurysm and aortic dissection occur at higher rates in SLE patients than in people without SLE and a longer disease duration is associated with a higher risk of these rare vascular complications.
OBJECTIVE: The objective of our study was to determine the incidence rates and risk factors of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus (SLE) using a nationwide population-based data set. METHODS: We conducted a retrospective cohort study using data from the Taiwan National Health Insurance database. Patients with SLE and age-, sex- and comorbidity-matched control patients without SLE were identified. The primary endpoint was the first occurrence of aortic aneurysm or aortic dissection. The incidence rate ratios (IRRs) were calculated based on a 95% confidence interval (CI). A Cox proportional-hazards model was used to evaluate the risk factors for aortic aneurysm and aortic dissection in the SLE cohort. RESULTS: Among the 15,209 patients with SLE (89.9% women and mean age of 38.3 years), 20 developed aortic aneurysm and 13 developed aortic dissection (overall incidence rate, 4.26 per 10,000 person-years). Compared with the control patients, the overall IRR for developing aortic aneurysm or aortic dissection was 3.34 (95% CI, 1.71-6.91; p < 0.001). The IRRs for aortic aneurysm or aortic dissection were 2.98 (95% CI, 1.41-6.70, p = 0.018) for women and 5.50 (95% CI, 1.10-53.15, p = 0.020) for men. Multivariate Cox regression analysis showed that age, male sex, an SLE diagnosis greater than three years prior and hypertension were associated with aortic aneurysm and aortic dissection. CONCLUSION:Aortic aneurysm and aortic dissection occur at higher rates in SLEpatients than in people without SLE and a longer disease duration is associated with a higher risk of these rare vascular complications.