Abstract
Objective
To assess the prevalence of atherosclerotic cardiovascular disease (ASCVD) and its
individual phenotypes of coronary artery disease (CAD), peripheral artery disease
(PAD), and cerebrovascular disease by age and sex in a large US cohort of hospitalized
patients with systemic lupus erythematosus (SLE).
Methods
A nested case-control study of adults with and without SLE was conducted from the
January 1, 2008, through December 31, 2014, National Inpatient Sample. Hospitalized
patients with SLE were matched (1:3) by age, sex, race, and calendar year to hospitalized
patients without SLE. The prevalences of CAD, PAD, and cerebrovascular disease were
evaluated, and associations with SLE were determined after adjustment for common cardiovascular
risk factors.
Results
Among the 252,676 patients with SLE and 758,034 matched patients without SLE, the
mean age was 51 years, 89% were women, and 49% were white. Patients with SLE had a
higher prevalence of ASCVD vs those without SLE (25.6% vs 19.2%; OR, 1.45; 95% CI,
1.44-1.47; P<.001). After multivariable adjustment, SLE was associated with a greater odds of
ASCVD (adjusted odds ratio [aOR], 1.46; 95% CI, 1.41-1.51). The association between
SLE and ASCVD was observed in women and men and was attenuated with increasing age.
Also, SLE was associated with increased odds of CAD (aOR, 1.42; 95% CI, 1.40-1.44),
PAD (aOR, 1.25; 95% CI, 1.22-1.28), and cerebrovascular disease (aOR, 1.68; 95% CI,
1.65-1.71).
Conclusion
In hospitalized US patients, SLE was associated with increased ASCVD prevalence, which
was observed in both sexes and was greatest in younger patients.
Abbreviations and Acronyms:
aOR (adjusted odds ratio), ASCVD (atherosclerotic cardiovascular disease), CAD (coronary artery disease), CKD (chronic kidney disease), ICD-9 (International Classification of Diseases, Ninth Revision), NIS (National Inpatient Sample), OR (odds ratio), PAD (peripheral artery disease), SLE (systemic lupus erythematosus)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 11, 2019
Footnotes
For Limelight, see page 1391
Grant Support: This work was supported, in part, by grants NIH R21AR071103 (R.C., J.P.B., J.S.B.) and T32HL098129 (N.R.S.) from the National Institutes of Health.
Potential Competing Interests: The authors report no competing interests.
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© 2019 Mayo Foundation for Medical Education and Research
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- In the Limelight: August 2019Mayo Clinic ProceedingsVol. 94Issue 8
