Fernando Briceño Moya1, Luis Francisco Pineda Galindo, Maximiliano García de la Peña. 1. From the *Departamento de Medicina Interna, Hospital de Especialidades Centro Médico Nacional "La Raza", IMSS, Seris y Zaachila S/N, Colonia La Raza, Delegación Azcapotzalco, Distrito Federal, México; and †Coordinación de Planeación de Infraestructura Médica, Instituto Mexicano del Seguro Social, Colonia Roma, Delegación Cuauhtémoc, Distrito Federal, México.
Abstract
BACKGROUND: Systemic lupus erythematosus is highly associated with premature atherosclerosis and cardiovascular events. The origin of this subclinical atherosclerosis has been attributed mainly to the inflammatory nature of the disease. OBJECTIVE: To assess the effect of long-term use of glucocorticoids on cardiovascular risk in patients with systemic lupus erythematosus. MATERIAL AND METHODS: We conducted a registry-based retrospective cohort study. We determined 2 periods: (1) Time 0, that is, time of diagnosis and (2) time 1, that is, when the study was finalized. At both times, the cardiovascular risk was evaluated using the Framingham scale and their scores were compared. Afterward, the change magnitude between the 2 times was evaluated and associated with the cumulative glucocorticoids dose. RESULTS: One hundred one patients were included. The mean ± SD age was 26.5 ± 5 years. Length of disease evolution was of 7.8 ± 4.9 years. There was an 8-point increase in the Framingham score, from -8.1 ± 4 to 0.8 ± 7; P < 0.0001. The correlation between the magnitude of the increase in Framingham score and their corresponding cumulative dose showed a coefficient of 0.88; P < 0.001. CONCLUSIONS: The glucocorticoids are a primary factor that influences cardiovascular risk. There is a directly proportional relationship between the cumulative glucocorticoid dose and the increase in cardiovascular risk.
BACKGROUND:Systemic lupus erythematosus is highly associated with premature atherosclerosis and cardiovascular events. The origin of this subclinical atherosclerosis has been attributed mainly to the inflammatory nature of the disease. OBJECTIVE: To assess the effect of long-term use of glucocorticoids on cardiovascular risk in patients with systemic lupus erythematosus. MATERIAL AND METHODS: We conducted a registry-based retrospective cohort study. We determined 2 periods: (1) Time 0, that is, time of diagnosis and (2) time 1, that is, when the study was finalized. At both times, the cardiovascular risk was evaluated using the Framingham scale and their scores were compared. Afterward, the change magnitude between the 2 times was evaluated and associated with the cumulative glucocorticoids dose. RESULTS: One hundred one patients were included. The mean ± SD age was 26.5 ± 5 years. Length of disease evolution was of 7.8 ± 4.9 years. There was an 8-point increase in the Framingham score, from -8.1 ± 4 to 0.8 ± 7; P < 0.0001. The correlation between the magnitude of the increase in Framingham score and their corresponding cumulative dose showed a coefficient of 0.88; P < 0.001. CONCLUSIONS: The glucocorticoids are a primary factor that influences cardiovascular risk. There is a directly proportional relationship between the cumulative glucocorticoid dose and the increase in cardiovascular risk.
Authors: Patricia Garcia-Garcia; Raquel Castejon; Pablo Tutor-Ureta; R A Silvestre; Susana Mellor-Pita; Carlos Jimenez-Ortiz; Miguel Yebra-Bango Journal: Clin Rheumatol Date: 2017-09-15 Impact factor: 2.980