The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis: a Danish nationwide population-based cohort study

TY - JOUR

T1 - The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis

T2 - a Danish nationwide population-based cohort study

AU - Hermansen, Marie-Louise

AU - Lindhardsen, Jesper

AU - Torp-Pedersen, Christian

AU - Faurschou, Mikkel

AU - Jacobsen, Søren

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Objective: . To assess the role of LN as a risk factor for myocardial infarction (MI), stroke and cardiovascular mortality (CVM) in patients with SLE.Methods: . The study was conducted using individual-level data from multiple nationwide registers. We identified a cohort of patients diagnosed with SLE and further determined if they had a diagnosis of LN during 1995-2011. Each SLE patient was matched with five population controls. Hazard ratios (HRs) were calculated to measure the risk of MI, stroke and CVM in SLE patients relative to population controls and in SLE patients with relative to without LN.Results: . We identified 1644 SLE patients with incident SLE; 233 of these patients had a diagnosis of incident LN during follow-up. The number of events in the SLE cohort was: 42 (MI), 74 (stroke) and 56 (CVM). For MI, the HR was 2.2 (95% CI: 1.4, 3.4) in SLE without LN and 18.3 (95% CI: 5.1, 65) in SLE with LN. The HR for LN was 8.5 (95% CI: 2.2, 33; P = 0.002). For stroke, HRs were 2.1 (95% CI: 1.5, 2.9) and 4.1 (95% CI: 1.9, 8.7) in SLE without and with LN, respectively, and we found no significant association with LN (P = 0.115). For CVM, the respective HRs were 1.6 (95% CI: 1.1, 2.4) and 7.8 (95% CI: 3.0, 20). The corresponding HR for LN was 4.9 (95% CI: 1.8, 13.7; P = 0.002).Conclusion: . The risk of MI and CVM, but not of stroke, is significantly higher in SLE patients with LN than SLE patients without LN.

AB - Objective: . To assess the role of LN as a risk factor for myocardial infarction (MI), stroke and cardiovascular mortality (CVM) in patients with SLE.Methods: . The study was conducted using individual-level data from multiple nationwide registers. We identified a cohort of patients diagnosed with SLE and further determined if they had a diagnosis of LN during 1995-2011. Each SLE patient was matched with five population controls. Hazard ratios (HRs) were calculated to measure the risk of MI, stroke and CVM in SLE patients relative to population controls and in SLE patients with relative to without LN.Results: . We identified 1644 SLE patients with incident SLE; 233 of these patients had a diagnosis of incident LN during follow-up. The number of events in the SLE cohort was: 42 (MI), 74 (stroke) and 56 (CVM). For MI, the HR was 2.2 (95% CI: 1.4, 3.4) in SLE without LN and 18.3 (95% CI: 5.1, 65) in SLE with LN. The HR for LN was 8.5 (95% CI: 2.2, 33; P = 0.002). For stroke, HRs were 2.1 (95% CI: 1.5, 2.9) and 4.1 (95% CI: 1.9, 8.7) in SLE without and with LN, respectively, and we found no significant association with LN (P = 0.115). For CVM, the respective HRs were 1.6 (95% CI: 1.1, 2.4) and 7.8 (95% CI: 3.0, 20). The corresponding HR for LN was 4.9 (95% CI: 1.8, 13.7; P = 0.002).Conclusion: . The risk of MI and CVM, but not of stroke, is significantly higher in SLE patients with LN than SLE patients without LN.

KW - Adult

KW - Cardiovascular Diseases

KW - Case-Control Studies

KW - Denmark

KW - Female

KW - Humans

KW - Lupus Erythematosus, Systemic

KW - Lupus Nephritis

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Risk Factors

KW - Stroke

KW - Journal Article

U2 - 10.1093/rheumatology/kew475

DO - 10.1093/rheumatology/kew475

M3 - Journal article

C2 - 28053276

SN - 1462-0324

VL - 56

SP - 709

EP - 715

JO - Rheumatology

JF - Rheumatology

IS - 5

ER -