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Svenungsson E et al. – SLE patients with the STAT4 risk allele had a strikingly increased risk of ICVD, comparable in magnitude to that of hypertension. Our results imply that a genetic predisposition is an important and previously unrecognized risk factor for ICVD in SLE, and that aPLs may be one underlying mechanism.

Exclusive Author Commentary
Elisabet Svenungsson, 09/21/09

Cardiovascular disease, both ischemic cerebrovascular and ischemic heart disease, is a a big clinical challenge and main cause of early mortality among patients with systemic lupus erythematosus (SLE). We were struck by the very high impact that STAT4 genotype had on the occurence of stroke/transitory ischemic attacks (TIA), which affected 10% of the 578 SLE patients in this study. The association with antiphospholipid antibodies was somewhat weaker but indicate one possible mechanism, which needs to be further investigated. Another important finding is that the risk factor profile for stroke/TIA and ischemic heart disease (myocardial infarction/angina) in our SLE patients differed considerably. STAT4 genotype was not associated with the latter and not with venous thromboembolic events.

   

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