Abstract
Objective. This study was performed to determine the prevalence of and associated risk factors for cardiovascular disease (CVD) in Latin American (LA) patients with systemic lupus erythematosus (SLE). Methods. First, a cross-sectional analytical study was conducted in 310 Colombian patients with SLE in whom CVD was assessed. Associated factors were examined by multivariate regression analyses. Second, a systematic review of the literature on CVD in SLE in LA was performed. Results. There were 133 (36.5%) Colombian SLE patients with CVD. Dyslipidemia, smoking, coffee consumption, and pleural effusion were positively associated with CVD. An independent effect of coffee consumption and cigarette on CVD was found regardless of gender and duration of disease. In the systematic review, 60 articles fulfilling the eligibility criteria were included. A wide range of CVD prevalence was found (4%–79.5%). Several studies reported ancestry, genetic factors, and polyautoimmunity as novel risk factors for such a condition. Conclusions. A high rate of CVD is observed in LA patients with SLE. Awareness of the observed risk factors should encourage preventive population strategies for CVD in patients with SLE aimed at facilitating the suppression of cigarette smoking and coffee consumption as well as at the tight control of dyslipidemia and other modifiable risk factors.
Highlights
Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease (AD), characterized by the production of numerous pathogenic autoantibodies [1]
Awareness of the observed risk factors should encourage preventive population strategies for cardiovascular disease (CVD) in patients with systemic lupus erythematosus (SLE) aimed at facilitating the suppression of cigarette smoking and coffee consumption as well as at the tight control of dyslipidemia and other modifiable risk factors
CVD: cardiovascular disease; SLE: systemic lupus erythematosus; β: β coefficient; Adjusted odds ratios (AOR): adjusted odds ratio; 95% confidence intervals (CI): 95% confidence interval. ∗The model was adjusted by gender and duration of the disease
Summary
Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease (AD), characterized by the production of numerous pathogenic autoantibodies [1]. Hormonal, and environmental factors and immunesystem aberrations contribute to the clinical expression of the disease [2]. The annual incidence and prevalence range from 1.4 to 11 cases per 100,000 population, and from 7.4 to 159.4 cases per 100,000 population, respectively [4] depending on a variety of factors, including age, gender, and ancestry. A bimodal mortality was described by Urowitz et al [5] characterized by an early peak in the first 3 years after diagnosis due to active disease, infections and glomerulonephritis, and a second peak, 4–20 years after SLE diagnosis, in which cardiovascular disease (CVD) is the main feature and cause of death. Overall mortality for patients with SLE has improved over the past 30 years, mortality due to CVD has remained almost the same [6]
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