Cardiovascular Complications in Patients with Systemic Lupus Erythematosus: A Retrospective Cohort Study of Epidemiology of Cardiovascular Risk Factors and Events in Patients with Systemic Lupus Erythematosus

Al Majarfi HS, Prashanth P and Al Wahshi HW

Published on: 2024-10-08

Abstract

Objectives: Systemic Lupus Erythematosus (SLE) is a common rheumatic autoimmune disease worldwide. Studies have shown that there is increased risk to develop both cardiovascular (CV) risk factors as well cardiovascular diseases (CVD) in patients with SLE. We aimed primarily to establish the common CV complications in patients diagnosed with SLE which includes coronary artery diseases, hemorrhagic and ischemic strokes and transient ischemic attacks. As secondary objectives we also looked at the association between SLE and risk factors to develop CVD and the association between the SLE disease severity using established risk score i.e. Systemic Lupus International Collaborating Clinics/ American College of Rheumatology Damage Index (SLICC/ACR DI) and the risk to develop cardiovascular events (CVEs).

Methods: We conducted a cross sectional retrospective observational study. This study included all the patients who attended Rheumatology Clinic in Royal Hospital, Muscat, Sultanate of Oman with the diagnosis of SLE from the period of 2006 to 2020. An institutional ethical approval was obtained.

Results: A total number of 577 patients were included in the study. 51.5% developed dyslipidemia, 6.1% developed hypertension and 2.9% developed diabetes mellitus after SLE diagnosis. Out of 577 patients, 4.9% developed CVEs with ischemic stroke as most occurring event. Among patient with CVEs, 75% had SLICC/ACR DI of ≤ 4 and 25% of patients had SLICC/ACR DI of ≥ 5.The association between development of CVE and SLICC/ACR DI ≥ 5 was statistically significant with P value of 0.001.

Conclusions: In this study, we have found that among the Omani patients who were diagnosed with SLE and followed-up, about 50% of them developed dyslipidemia, which is high, but comparable to few studies and very low percentage developed hypertension and diabetes mellitus. Overall, < 5% developed CVEs which is low when compared to Western countries. In addition, patients with higher SLICC/ACR DI score were more vulnerable to develop CVEs which is similar as in other studies and so we suggest to closely follow up and screen SLE patients with high SLICC/ACR DI score ≥ 5 for CV risk factors and events.