Background Systemic lupus erythematosus (SLE) is a chronic and multisystemic autoimmune disease. Higher prevalence of traditional and disease associated risk factors, such as corticosteroids and accelerated atherosclerosis due to chronic inflammation, result in an increased cardiovascular risk. Age and corticosteroid use have been described as cardiovascular risk factors but there is controversy surrounding antimalarials as a protective factor. Our objective is to analyze associated factors with the presentation of cardiovascular events such as high blood pressure (HBP), acute myocardial infarction (AMI), stroke and thromboembolic disease (TED)
Methods A cross-sectional study was done with 1175 records of patients with SLE that fulfilled either ACR 1997 of SLICC 2012 classification criteria that had been in medical care between 2015 and 2017 in a rheumatology specialized institution in six cities of Colombia. We describe sociodemographic, clinical and immunoserological characteristics and a comparative analysis was done with chi2 and Mann Whitney’s U with a combined outcome of cardiovascular disease obtaining an OR of crude associations that were adjusted for several variables
Results Women represented 91% of the cohort with a median age of 44 years (IQR 21) and 8 years of disease duration (IQR 11) with a mean age at diagnosis of 32 years, 5,4% were active smokers and 15% had smoked in the past. Cardiovascular events were found in 32% of the patients with HT as the most common. Other cardiovascular outcomes such as stroke, TED and AMI were infrequent with a prevalence of 3.3%, 2.9% and 2% respectively. In bivariate analysis, age >36 years and corticosteroid use were associated with a significantly higher risk, while the use of antimalarials for more than 6 years was found to protect for cardiovascular risk with no difference between chloroquine and hydroxychloroquine use (table 1)
Conclusions Our cohort is comparable with other SLE cohorts regarding the frequency of cardiovascular events. Up to 32% of the described population presented a cardiovascular event and arterial hypertension was the most frequent. Continuous use of antimalarials for more than 6 years has a protective effect against cardiovascular events such as arterial hypertension, stroke, acute myocardial infarction and thromboembolic disease. The benefit seen only after 6 years of continuous use probably reflects the need of a long period of time before some of the potential benefits of these medications are seen
Funding Source(s): None
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