Shrilekha Sairam1, Amit Sureen2, Jesus Gutierrez2, The Q Dang2, Kunal Mishra2. 1. Division of Rheumatology, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech Health Sciences Center El Paso, El Paso, TX, USA. Shrilekha.Sairam@ttuhsc.edu. 2. Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Ave, El Paso, TX, 79905, USA.
Abstract
PURPOSE OF THE REVIEW: To review cardiovascular outcomes (CVE) in systemic lupus erythematosus (SLE) that evolves over time. RECENT FINDINGS: Inception cohorts now report long-term data, and large population registries add to our knowledge. Mortality and cardiovascular morbidity remain high with a risk ratio of 2-3. SLE disease activity-related inflammation accounts for higher CVE incidence ratio in the first year following diagnosis with accelerated atherosclerosis contributing to CVE in about a quarter to a third of the patients later in the disease course. Immunomodulation and disease control are associated with improved cardiovascular outcomes. Validation of modified risk stratification tools and studies evaluating primary prevention with aspirin and hydroxychloroquine are reported. Increased awareness of high mortality associated with cardiac inflammation, improved outcomes with early disease control, aggressive management of risk factors, hypertension, obesity, and high cholesterol with modifying risk stratification will result in more favorable outcomes in SLE patients.
PURPOSE OF THE REVIEW: To review cardiovascular outcomes (CVE) in systemic lupus erythematosus (SLE) that evolves over time. RECENT FINDINGS: Inception cohorts now report long-term data, and large population registries add to our knowledge. Mortality and cardiovascular morbidity remain high with a risk ratio of 2-3. SLE disease activity-related inflammation accounts for higher CVE incidence ratio in the first year following diagnosis with accelerated atherosclerosis contributing to CVE in about a quarter to a third of the patients later in the disease course. Immunomodulation and disease control are associated with improved cardiovascular outcomes. Validation of modified risk stratification tools and studies evaluating primary prevention with aspirin and hydroxychloroquine are reported. Increased awareness of high mortality associated with cardiac inflammation, improved outcomes with early disease control, aggressive management of risk factors, hypertension, obesity, and high cholesterol with modifying risk stratification will result in more favorable outcomes in SLE patients.
Authors: Adelina Yafasova; Emil L Fosbøl; Morten Schou; Bo Baslund; Mikkel Faurschou; Kieran F Docherty; Pardeep S Jhund; John J V McMurray; Guoli Sun; Søren L Kristensen; Christian Torp-Pedersen; Lars Køber; Jawad H Butt Journal: J Am Coll Cardiol Date: 2021-04-13 Impact factor: 24.094
Authors: Murray B Urowitz; Dafna D Gladman; Vernon Farewell; Jiandong Su; Juanita Romero-Diaz; Sang-Cheol Bae; Paul R Fortin; Jorge Sanchez-Guerrero; Ann Elaine Clarke; Sasha Bernatsky; Caroline Gordon; John G Hanly; Daniel J Wallace; David A Isenberg; Anisur Rahman; Joan T Merrill; Ellen Ginzler; Graciela S Alarcón; W Winn Chatham; Michelle A Petri; Ian N Bruce; Munther A Khamashta; Cynthia Aranow; Mary Anne Dooley; Susan Manzi; Rosalind Ramsey-Goldman; Ola Nived; Andreas Jönsen; Kristján Steinsson; Asad A Zoma; Guillermo Ruiz-Irastorza; S Sam Lim; Kenneth C Kalunian; Murat Ỉnanç; Ronald van Vollenhoven; Manuel Ramos-Casals; Diane L Kamen; Soren Jacobsen; Christine A Peschken; Anca Askanase; Thomas Stoll Journal: Arthritis Rheumatol Date: 2020-08-25 Impact factor: 10.995