Article Text
Abstract
Background Cardiovascular disease (CVD) is the leading cause of death worldwide and this risk is increased in patients with SLE who may not conform to traditional cardiovascular risk profiles.
Aims To determine the prevalence of high CVD risk among patients with SLE calculated using different risk calculators, and to characterise those identified as high risk.
Methods A cross-sectional analysis to estimate CVD risk using the Framingham Risk Equation (Framingham score) and an SLE-specific CVD risk equation (SLE score) was undertaken using data from a single centre cohort. The characteristics of patients identified as ‘high risk’ by the SLE score only (the ‘missed group’) were compared with those identified by the Framingham score (the ‘conventional group’).
Results 146 patients were included; 22 (15%) and 44 (30%) were determined to be at ‘high risk’ based on the Framingham and SLE scores, respectively. Patients in the ‘missed group’ were less likely to have traditional risk factors and were more likely to be female (81% vs 50%; p=0.03), younger (mean age 54 vs 69 years p<0.01) and have lower systolic blood pressure (132 vs 143 mm Hg; p=0.05). Of those deemed high risk, only a minority were treated to target blood pressure and lipid levels.
Conclusions A large proportion of patients with SLE could be re-classified as high risk using a formula that incorporates SLE disease-related parameters. These patients have different profiles to those identified using a conventional risk model. Optimal CVD risk assessment and management warrants further attention in SLE.
- systemic lupus erythematosus
- cardiovascular risk
- risk assessment
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Footnotes
Contributors AYH developed the concept for this project and is the guarantor. DB analysed the data and composed the original draft. EFM and RLK monitored data collection throughout the Lupus Registry and revised the draft paper.
Funding This research received no specific grant from any agency in the public or commercial sectors.
Disclaimer The views expressed in this article are of the authors and not of Monash Health.
Competing interests None declared.
Patient consent This was a retrospective study carried out on consenting patients of the Monash Lupus Clinic Database.
Ethics approval This study was approved by the Monash Health Human Research Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Access to de-identified data from the Monash Lupus Clinic and Australian Lupus Registry is available in accordance with the Australian Lupus Registry and Biobank Data and Biospecimen Use Policy and Procedures. Researchers interested in using the study data used for this study or data from the Monash Lupus Clinic and Australian Lupus Registry and Biobank more broadly should make an enquiry via the 'Contact Us' page on the Australian Lupus Registry website (https://www.lupusregistry.com/contact-us).