Please use this identifier to cite or link to this item: https://repository.monashhealth.org/monashhealthjspui/handle/1/52022
Title: Prevalence and target attainment of traditional cardiovascular risk factors in patients with systemic lupus erythematosus: a cross-sectional study including 3401 individuals from 24 countries.
Authors: Bolla E.;Semb A.G.;Kerola A.M.;Ikdahl E.;Petri M.;Pons-Estel G.J.;Karpouzas G.A.;Sfikakis P.P.;Quintana R.;Misra D.P.;Borba E.F.;Garcia-de la Torre I.;Popkova T.V.;Artim-Esen B.;Troldborg A.;Fragoso-Loyo H.;Ajeganova S.;Yazici A.;Aroca-Martinez G.;Direskeneli H.;Ugarte-Gil M.F.;Mosca M.;Goyal M.;Svenungsson E.;Macieira C.;Hoi A. ;Lerang K.;Costedoat-Chalumeau N.;Tincani A.;Mirrakhimov E.;Acosta Colman I.;Danza A.;Massardo L.;Blagojevic J.;Yilmaz N.;Tegzova D.;Yavuz S.;Korkmaz C.;Hachulla E.;Moreno Alvarez M.J.;Munoz-Louis R.;Pantazis N.;Tektonidou M.G.;Bellomio V.;Cavazzana I.;Khmelinskii N.;Monticielo O.A.;Portela Hernandez M.;Saavedra Salinas M.A.;Scolnik M.;Silva Montandon A.C.;Yilmaz E.;Zucchi D.
Monash Health Department(s): Rheumatology
Institution: (Bolla, Sfikakis, Tektonidou) Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
(Semb, Ikdahl) Preventive Cardio-Rheuma Clinic, Division of Research and Innovation, REMEDY Centre, Diakonhjemmet Hospital, Oslo, Norway
(Kerola) Department of Internal Medicine, Paijat-Hame Central Hospital, Lahti, Finland
(Kerola) Faculty of Medicine, University of Helsinki, Helsinki, Finland
(Petri) Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
(Pons-Estel) Research Unit, Argentine Society of Rheumatology, Buenos Aires, Argentina
(Karpouzas) Division of Rheumatology, Harbor-UCLA Medical Center, Torrance, CA, United States
(Karpouzas) The Lundquist Institute, Torrance, CA, United States
(Quintana) Grupo Orono, Centro Regional de Enfermedades Autoinmunes y Reumaticas, Rosario, Argentina
(Misra) Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
(Borba) Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Garcia-de la Torre) Departamento de Inmunologia y Reumatologia, Hospital General de Occidente, Jalisco, Mexico
(Garcia-de la Torre) Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
(Popkova) VA Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
(Artim-Esen) Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
(Troldborg) Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
(Troldborg) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
(Troldborg) Department of Biomedicine, Aarhus University, Aarhus, Denmark
(Fragoso-Loyo) Immunology and Rheumatology Department, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
(Ajeganova) Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
(Svenungsson) Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
(Ajeganova) Department of Clinical Sciences, Rheumatology Division, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
(Yazici) Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
(Aroca-Martinez) Universidad Simon Bolivar, Barranquilla, Colombia
(Direskeneli) Division of Rheumatology, Department of Internal Medicine, Marmara University, School of Medicine, Istanbul, Turkey
(Ugarte-Gil) Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistemicas, Universidad Cientifica del Sur, Lima, Peru
(Ugarte-Gil) Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
(Mosca) Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Goyal) Division of Rheumatology, CARE Pain and Arthritis Centre, Udaipur, India
(Svenungsson) Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
(Macieira) Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal
(Hoi) Department of Rheumatology, Monash Health, Clayton, VIC, Australia
(Hoi) School of Clinical Science, Monash University, Clayton, VIC, Australia
(Lerang) Department of Rheumatology, Oslo University Hospital, Oslo, Norway
(Costedoat-Chalumeau) National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hopital Cochin, AP-HP Centre, Universite Paris Cite, Paris, France
(Tincani) Rheumatology and Clinical Immunology Unit-ASST Spedali Civili, Brescia, Italy
(Mirrakhimov) Kyrgyz State Medical Academy, Bishkek, Kyrgyztan
(Acosta Colman) Department of Rheumatology, Universidad Nacional de Asuncion, Asuncion, Paraguay
(Danza) Department of Internal Medicine, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
(Massardo) Centro de Biologia Celular y Biomedicina, Facultad de Medicina y Ciencia, Universidad San Sebastian, Santiago, Chile
(Blagojevic) Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
(Blagojevic) Department of Geriatric Medicine, Division of Rheumatology and Scleroderma Unit, AOUC, Florence, Italy
(Yilmaz) Rheumatology Department, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
(Tegzova) Institute of Rheumatology, Prague, Czechia
(Yavuz) Department of Internal Medicine, Division of Rheumatology, Istanbul Bilim University, Istanbul, Turkey
(Korkmaz) Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
(Hachulla) Department of Internal Medicine and Clinical Immunology, National Referral Centre for Rare Systemic Auto-Immune and Auto-inflammatory Diseases, University of Lille, Inserm, CHU Lille, U1286 - INFINITE, University of Lille, Lille, France
(Moreno Alvarez) Servicio Reumatologia, Hospital Luis Vernaza, Universidad de Especialidades Espiritu Santo, Guayaquil, Ecuador
(Munoz-Louis) Servicio de Reumatologia, Hospital Docente Padre Billini, Santo Domingo, Dominican Republic
(Pantazis) Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Issue Date: 22-Jun-2024
Copyright year: 2024
Publisher: Elsevier Ltd
Place of publication: United Kingdom
Publication information: The Lancet Rheumatology. 6(7) (pp e447-e459), 2024. Date of Publication: July 2024.
Journal: The Lancet Rheumatology
Abstract: Background: Systemic lupus erythematosus (SLE) is characterised by increased cardiovascular morbidity and mortality risk. We aimed to examine the prevalence of traditional cardiovascular risk factors and their control in an international survey of patients with systemic lupus erythematosus. Method(s): In this multicentre, cross-sectional study, cardiovascular risk factor data from medical files of adult patients (aged >=18) with SLE followed between Jan 1, 2015, and Jan 1, 2020, were collected from 24 countries, across five continents. We assessed the prevalence and target attainment of cardiovascular risk factors and examined potential differences by country income level and antiphospholipid syndrome coexistence. We used the Systemic Coronary Risk Evaluation algorithm for cardiovascular risk estimation, and the European Society of Cardiology guidelines for assessing cardiovascular risk factor target attainment. People with lived experience were not involved in the research or writing process. Finding(s): 3401 patients with SLE were included in the study. The median age was 43.0 years (IQR 33-54), 3047 (89.7%) of 3396 patients were women, 349 (10.3%) were men, and 1629 (48.1%) of 3390 were White. 556 (20.7%) of 2681 patients had concomitant antiphospholipid syndrome. We found a high cardiovascular risk factor prevalence (hypertension 1210 [35.6%] of 3398 patients, obesity 751 [23.7%] of 3169 patients, and hyperlipidaemia 650 [19.8%] of 3279 patients), and suboptimal control of modifiable cardiovascular risk factors (blood pressure [target of <130/80 mm Hg], BMI, and lipids) in the entire SLE group. Higher prevalence of cardiovascular risk factors but a better blood pressure (target of <130/80 mm Hg; 54.9% [1170 of 2132 patients] vs 46.8% [519 of 1109 patients]; p<0.0001), and lipid control (75.0% [895 of 1194 patients] vs 51.4% [386 of 751 patients], p<0.0001 for high-density lipoprotein [HDL]; 66.4% [769 of 1158 patients] vs 60.8% [453 of 745 patients], p=0.013 for non-HDL; 80.9% [1017 of 1257 patients] vs 61.4% [486 of 792 patients], p<0.0001 for triglycerides]) was observed in patients from high-income versus those from middle-income countries. Patients with SLE with antiphospholipid syndrome had a higher prevalence of modifiable cardiovascular risk factors, and significantly lower attainment of BMI and lipid targets (for low-density lipoprotein and non-HDL) than patients with SLE without antiphospholipid syndrome. Interpretation(s): High prevalence and inadequate cardiovascular risk factor control were observed in a large multicentre and multiethnic SLE cohort, especially among patients from middle-income compared with high-income countries and among those with coexistent antiphospholipid syndrome. Increased awareness of cardiovascular disease risk in SLE, especially in the above subgroups, is urgently warranted. Funding(s): None.Copyright © 2024 Elsevier Ltd
DOI: http://monash.idm.oclc.org/login?url=https://dx.doi.org/10.1016/S2665-9913%2824%2900090-0
URI: https://repository.monashhealth.org/monashhealthjspui/handle/1/52022
Type: Article
Subjects: antiphospholipid syndrome
blood pressure
cardiology
cardiovascular risk
cardiovascular risk factor
hyperlipidemia
Type of Clinical Study or Trial: Observational study (cohort, case-control, cross sectional, or survey)
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