Association of systemic lupus erythematosus with angiographically-defined coronary artery disease: A retrospective cohort study
Arthritis Care & Research , 06/29/2012
Kaul MS et al. – In this selected population, systemic lupus erythematosus (SLE) was significantly associated with the presence of coronary artery disease (CAD) as defined by coronary angiography, the gold standard for assessing flow–limiting lesions in this disease. The patients with SLE showed a similar severity of CAD as the controls despite having less than half the rate of diabetes and being 20 years younger.Methods
- The authors identified SLE patients (N=86) and controls matched by sex and year of cardiac catheterization (N=258) undergoing cardiac catheterization for the evaluation of CAD (median follow up of 4.3 years).
- Multivariable logistic regression was used to determine if SLE was associated with obstructive CAD defined as ò 70% stenosis in a major epicardial coronary artery.
- Risk adjusted survival differences between the two groups were assessed using Cox proportional hazards modeling.
- SLE patients (85% female) were younger than non–SLE patients (median age 49 years vs. 70 years, p>0.001) and were less likely to have diabetes and hyperlipidemia, but had similar rates of hypertension (70% vs.71%, p=0.892).
- In unadjusted analyses, SLE patients and non–SLE patients had similar rates of obstructive CAD by angiography (52% vs. 62% overall p=0.11).
- After adjustment for known CAD risk factors, SLE was associated with a significantly increased likelihood of CAD (OR 2.24, 95% CI: 1.08, 4.67).
- SLE was also associated with a non–significant increase in all–cause mortality (HR 1.683, 95% CI: 0.98, 2.89 p=0.060).