Characteristics and traditional cardiovascular risk factors in patients with SLE (n=129) with and without history of adverse pregnancy outcomes*
| Characteristics/CVD risk factors at baseline SOLVABLE visit | Patients with adverse pregnancy outcomes n=56 | Patients with no adverse pregnancy outcomes n=73 | p Value |
|---|---|---|---|
| Demographics | |||
| Age (years, mean±SD) | 44.5±9.7 | 44.4±9.7 | 0.948 |
| Age at menopause (years, mean±SD) | 37.4±8.9 | 43.8±6.9 | 0.005 |
| Traditional CVD risk factors | |||
| Body mass index, kg/m2, mean±SD | 29.4±8.5 | 27.7±7.4 | 0.225 |
| Waist-hip ratio, mean±SD | 0.86±0.12 | 0.86±0.16 | 0.713 |
| Hypertension†, n (%) | 37 (66.1) | 34 (46.6) | 0.027 |
| Hypercholesterolaemia†, n (%) | 17 (30.4) | 21 (28.8) | 0.844 |
| Diabetes†, n (%) | 8 (14.3) | 4 (5.5) | 0.088 |
| Current smoker, n (%) | 10 (17.9) | 8 (11.0) | 0.109 |
| Family history of MI, n (%) | 23 (41.1) | 28 (38.4) | 0.957 |
| Total cholesterol, mg/dL, mean±SD | 188.3±41.3 | 191.8±36.7 | 0.602 |
| LDLc, mg/dL, mean±SD | 105.6±30.4 | 112.0±32.8 | 0.263 |
| HDLc, mg/dL, mean±SD | 54.9±16.6 | 55.8±14.5 | 0.727 |
| Triglycerides, mg/dL, mean±SD | 141.0±99.2 | 124.1±75.6 | 0.276 |
| Median (IQR) | 110.5 (83.3, 172.5) | 102 (81.5, 151) | 0.287 |
| SLE characteristics | |||
| SLE disease duration, years, mean±SD | 13.2±8.6 | 11.4±7.4 | 0.204 |
| Current CS use, n (%) | 30 (53.6) | 29 (39.7) | 0.118 |
| CS use ever, n (%) | 46 (82.1) | 53 (72.6) | 0.176 |
| Duration of CS use, years, mean±SD | 8.5±7.7 | 6.9±5.9 | 0.253 |
| Current HCQ use, n (%) | 37 (66.1) | 53 (72.6) | 0.423 |
| Current immunosuppressant use‡, n (%) | 23 (41.1) | 19 (26.0) | 0.71 |
| Immunosuppressant‡ use ever, n (%) | 28 (50) | 35 (47.9) | 0.817 |
| SLICC-DI, mean±SD | 2.1±1.8 | 1.4±1.7 | 0.042 |
| Median (IQR) | 2 (0.25, 3) | 1 (0,2) | 0.032 |
| SLEDAI, mean±SD | 4.8±4.3 | 3.8±3.5 | 0.145 |
| Median (IQR) | 4 (2, 6) | 4 (0.5, 6) | 0.184 |
| Renal disease§, n (%) | 16 (28.6) | 21 (28.8) | 0.981 |
| Anti-phospholipid status¶, n (%) | 12 (21.8) | 22 (30.1) | 0.292 |
| Inflammatory markers | |||
| CRP, median (IQR) | 1.6 (0.6–6.2) | 1.2 (0.5–5.1) | 0.277 |
| HCY, mean±SD | 13.0±8.3 | 11.1±3.9 | 0.082 |
| ICAM, mean±SD | 270.2±150.9 | 292.3±96.8 | 0.317 |
| VCAM, mean±SD | 1087.7±671.0 | 1038.2±48.5 | 0.630 |
| E-selectin, mean±SD | 69.7±30.1 | 65.8±35.3 | 0.515 |
Data presented as mean±SD for normally distributed continuous variables, median (IQR) for skewed continuous variables, and n (%) for categorical variables.
*Adverse pregnancy outcomes include pre-eclampsia, low birthweight infants or preterm birth.
†Hypertension present if any of the following: self-reported history of hypertension, systolic blood pressure>140, diastolic blood pressure>90, or taking antihypertensive medications; present if any of the following: self-reported history of high cholesterol or taking cholesterol lowering medications; diabetes present if self-reported history of diabetes or fasting glucose >126 mg/dL.
‡Immunosuppressants included: cyclophosphamide, azathioprine, methotrexate, mycophenolate mofetil, ciclosporin and tacrolimus.
§Renal disease was defined as being present if the subject had fulfilled ACR classification criteria for lupus renal involvement or renal biopsy with WHO Class IIb, III, IV or V lupus nephritis.
¶Anti-phospholipid status included any one of the following positive at the study visit: anticardiolipin antibody IgG or IgM isotype or lupus anticoagulant.
ACR, American College of Rheumatology; CRP, C reactive protein; CS, corticosteroid; CVD, cardiovascular disease; HCQ, hydroxychloroquine; HCY, homocysteine; HDLc, high density lipoprotein cholesterol; ICAM, intracellular adhesion molecule; LDLc, low density lipoprotein cholesterol; MI, myocardial infarction; SLE, systemic lupus erythematosus; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index; SLICC-DI, Systemic Lupus International Collaborating Clinics Damage Index; VCAM, vascular cell adhesion molecule; SOLVABLE, Study of Long-term Vascular and Bone Outcomes in Lupus Erythematosus.