Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian state
Objectives Cardiovascular complications became a notable cause of morbidity and mortality in patients with lupus as therapeutic advancements became more efficient at managing other complications. The Appalachian community in Kentucky has a higher prevalence of traditional cardiovascular risk factors...
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| Language: | English |
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BMJ Publishing Group
2021-04-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/8/1/e000467.full |
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| author | Elise Danielle McVeigh Amna Batool Arnold Stromberg Ahmed Abdel-Latif Nayef Mohammed Kazzaz |
| author_facet | Elise Danielle McVeigh Amna Batool Arnold Stromberg Ahmed Abdel-Latif Nayef Mohammed Kazzaz |
| author_sort | Elise Danielle McVeigh |
| collection | DOAJ |
| description | Objectives Cardiovascular complications became a notable cause of morbidity and mortality in patients with lupus as therapeutic advancements became more efficient at managing other complications. The Appalachian community in Kentucky has a higher prevalence of traditional cardiovascular risk factors, predisposing them to cardiovascular events. Namely, the mean body mass index of the members of the Kentucky Appalachian community was reported at 33 kg/m2 and 94.3% of male members of this community use tobacco. We sought to identify risk factors that predispose patients with lupus to cardiovascular morbidities and examine the effect of immunomodulatory drugs.Methods We identified 20 UKHS patients having both a lupus diagnosis and experienced at least one cardiovascular event. We chose three controls matched for birth-year ±5 years to each case. In a case–control design, we analysed lupus manifestations, cardiovascular risk factors and immunosuppressive therapies. We collected Systemic Lupus Erythematosus Disease Activity Index 2000 disease activity index during the cardiovascular event.Results We identified 308 patients with lupus from among all University of Kentucky Health System patients. 20 (6.5%) of such patients with lupus were confirmed to cardiovascular complication. Of those 20, 7 (35%) had experienced myocardial infarction, 10 (50%) had experienced stroke and 4 (20%) had peripheral ischaemia. Tobacco use and male gender were the only traditional cardiovascular risk factors higher in the cases group. Hydroxychloroquine and steroids were less utilised in the cases than in the controls (70% vs 100% in hydroxychloroquine, 30% vs 82% in steroids). Venous thrombosis was found to be significantly higher in the cases. On multivariate analysis, venous thrombosis remained significant.Conclusion Despite tobacco use partially explaining the increased risk of cardiovascular disease among the cases group, the higher prevalence of venous thrombosis in the cases group suggests lupus as a potential additional risk factor of cardiovascular morbidity among patients with lupus in this Appalachian community. |
| format | Article |
| id | doaj-art-58d573ceb68a4b5f925b8c14a712c5a2 |
| institution | Kabale University |
| issn | 2053-8790 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj-art-58d573ceb68a4b5f925b8c14a712c5a22024-12-16T21:30:09ZengBMJ Publishing GroupLupus Science and Medicine2053-87902021-04-018110.1136/lupus-2020-000467Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian stateElise Danielle McVeigh0Amna Batool1Arnold Stromberg2Ahmed Abdel-Latif3Nayef Mohammed Kazzaz4Internal Medicine Department, Division of Rheumatology, University of Kentucky, Lexington, Kentucky, USAInternal Medicine Department, Division of Rheumatology, University of Kentucky, Lexington, Kentucky, USADepartment of Statistics, University of Kentucky, Lexington, Kentucky, USAInternal Medicine, Division of Cardiology, University of Kentucky, Lexington, Kentucky, USAInternal Medicine Department, Division of Rheumatology, University of Kentucky, Lexington, Kentucky, USAObjectives Cardiovascular complications became a notable cause of morbidity and mortality in patients with lupus as therapeutic advancements became more efficient at managing other complications. The Appalachian community in Kentucky has a higher prevalence of traditional cardiovascular risk factors, predisposing them to cardiovascular events. Namely, the mean body mass index of the members of the Kentucky Appalachian community was reported at 33 kg/m2 and 94.3% of male members of this community use tobacco. We sought to identify risk factors that predispose patients with lupus to cardiovascular morbidities and examine the effect of immunomodulatory drugs.Methods We identified 20 UKHS patients having both a lupus diagnosis and experienced at least one cardiovascular event. We chose three controls matched for birth-year ±5 years to each case. In a case–control design, we analysed lupus manifestations, cardiovascular risk factors and immunosuppressive therapies. We collected Systemic Lupus Erythematosus Disease Activity Index 2000 disease activity index during the cardiovascular event.Results We identified 308 patients with lupus from among all University of Kentucky Health System patients. 20 (6.5%) of such patients with lupus were confirmed to cardiovascular complication. Of those 20, 7 (35%) had experienced myocardial infarction, 10 (50%) had experienced stroke and 4 (20%) had peripheral ischaemia. Tobacco use and male gender were the only traditional cardiovascular risk factors higher in the cases group. Hydroxychloroquine and steroids were less utilised in the cases than in the controls (70% vs 100% in hydroxychloroquine, 30% vs 82% in steroids). Venous thrombosis was found to be significantly higher in the cases. On multivariate analysis, venous thrombosis remained significant.Conclusion Despite tobacco use partially explaining the increased risk of cardiovascular disease among the cases group, the higher prevalence of venous thrombosis in the cases group suggests lupus as a potential additional risk factor of cardiovascular morbidity among patients with lupus in this Appalachian community.https://lupus.bmj.com/content/8/1/e000467.full |
| spellingShingle | Elise Danielle McVeigh Amna Batool Arnold Stromberg Ahmed Abdel-Latif Nayef Mohammed Kazzaz Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian state Lupus Science and Medicine |
| title | Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian state |
| title_full | Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian state |
| title_fullStr | Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian state |
| title_full_unstemmed | Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian state |
| title_short | Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian state |
| title_sort | cardiovascular complications of systemic lupus erythematosus impact of risk factors and therapeutic efficacy a tertiary centre experience in an appalachian state |
| url | https://lupus.bmj.com/content/8/1/e000467.full |
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