SLE and antiphospholipid antibody syndrome as risk factors for acute coronary syndrome in young patients

By Scott Cunningham, MD, PhD
Published March 29, 2022

Key Takeaways

  • Systemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APLS) are risk factors for acute coronary syndrome (ACS) in patients < 40 years of age as well as patients > 40 years of age, but the risk is less in patients > 40 years of age.

Although traditional cardiovascular (CV) risk factors for ACS have been established for patients < 40 and > 40 years of age, the effect of secondary diagnoses with SLE and APLS on CV risk, if any, is not known.

Why This Study Matters

CV risk factors, whether traditional or non-traditional, can often be mitigated with a corresponding decrease in ACS risk.  The purpose of the current study was to determine the effect of two autoimmune rheumatic diseases (SLE and APLS) on ACS risk.

Study Design

The National Inpatient Sample database (2016-2018) served as the source for data in this study. Eligible patients were adults who were hospitalized due to ACS as the primary diagnosis, with or without SLE or APLS as a secondary diagnosis. The patients were grouped according to age as follows:  < 40 years; and > 40 years. The primary outcome was ACS.

Results and Conclusions

Based on the National Inpatient Sample database (2016-2018), a total of 55,050 and 1,966,234 patients < 40 and > 40 years of age, respectively, were hospitalized with a primary diagnosis of ACS.

Both groups of patients had traditional CV risk factors for ACS.  Among the patients < 40 years of age, SLE (OR = 2.18) and APLS (OR = 2.18) were strong risk factors for ACS.  Among the patients > 40 years of age, secondary diagnoses with SLE or APLS were not independently associated with risk for ACS.

Related Research

Consider the findings from a similar research study:

  • Patients hospitalized for ACS with co-existing systemic sclerosis had increased inpatient mortality compared to patients without systemic sclerosis (Source).

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