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Association of systemic lupus erythematosus with angiographically defined coronary artery disease: a retrospective cohort study.

Publication ,  Journal Article
Kaul, MS; Rao, SV; Shaw, LK; Honeycutt, E; Ardoin, SP; St Clair, EW
Published in: Arthritis Care Res (Hoboken)
February 2013

OBJECTIVE: To determine if systemic lupus erythematosus (SLE) is associated with a higher prevalence of coronary artery disease (CAD) in select patients undergoing coronary angiography. We compared the extent of angiographic abnormalities, CAD risk factors, and all-cause mortality in SLE patients with non-SLE controls. METHODS: We identified SLE patients (n = 86) and controls matched by sex and year of cardiac catheterization (n = 258) undergoing cardiac catheterization for the evaluation of CAD (median followup duration of 4.3 years). Multivariable logistic regression was used to determine if SLE was associated with obstructive CAD, defined as ≥70% stenosis in a major epicardial coronary artery. Risk-adjusted survival differences between the 2 groups were assessed using Cox proportional hazards modeling. RESULTS: The SLE patients (85% women) were younger than the non-SLE patients (median age 49 years versus 70 years; P < 0.001) and were less likely to have diabetes mellitus and hyperlipidemia, but had similar rates of hypertension (70% versus 71%; P = 0.892). In unadjusted analyses, SLE and non-SLE patients had similar rates of obstructive CAD by angiography (52% versus 62%; overall P = 0.11). After adjustment for known CAD risk factors, SLE was associated with a significantly increased likelihood of CAD (odds ratio 2.24 [95% confidence interval (95% CI) 1.08-4.67]). SLE was also associated with a nonsignificant increase in all-cause mortality (hazard ratio 1.683 [95% CI 0.98-2.89], P = 0.060). CONCLUSION: In this selected population, SLE was significantly associated with the presence of CAD as defined by coronary angiography, the gold standard for assessing flow-limiting lesions in this disease. The patients with SLE showed a similar severity of CAD as the controls despite having less than half the rate of diabetes mellitus and being 20 years younger.

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Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

February 2013

Volume

65

Issue

2

Start / End Page

266 / 273

Location

United States

Related Subject Headings

  • Retrospective Studies
  • North Carolina
  • Middle Aged
  • Male
  • Lupus Erythematosus, Systemic
  • Logistic Models
  • Humans
  • Female
  • Coronary Artery Disease
  • Coronary Angiography
 

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Kaul, M. S., Rao, S. V., Shaw, L. K., Honeycutt, E., Ardoin, S. P., & St Clair, E. W. (2013). Association of systemic lupus erythematosus with angiographically defined coronary artery disease: a retrospective cohort study. Arthritis Care Res (Hoboken), 65(2), 266–273. https://doi.org/10.1002/acr.21782
Kaul, Mala S., Sunil V. Rao, Linda K. Shaw, Emily Honeycutt, Stacy P. Ardoin, and E William St Clair. “Association of systemic lupus erythematosus with angiographically defined coronary artery disease: a retrospective cohort study.Arthritis Care Res (Hoboken) 65, no. 2 (February 2013): 266–73. https://doi.org/10.1002/acr.21782.
Kaul MS, Rao SV, Shaw LK, Honeycutt E, Ardoin SP, St Clair EW. Association of systemic lupus erythematosus with angiographically defined coronary artery disease: a retrospective cohort study. Arthritis Care Res (Hoboken). 2013 Feb;65(2):266–73.
Kaul, Mala S., et al. “Association of systemic lupus erythematosus with angiographically defined coronary artery disease: a retrospective cohort study.Arthritis Care Res (Hoboken), vol. 65, no. 2, Feb. 2013, pp. 266–73. Pubmed, doi:10.1002/acr.21782.
Kaul MS, Rao SV, Shaw LK, Honeycutt E, Ardoin SP, St Clair EW. Association of systemic lupus erythematosus with angiographically defined coronary artery disease: a retrospective cohort study. Arthritis Care Res (Hoboken). 2013 Feb;65(2):266–273.
Journal cover image

Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

February 2013

Volume

65

Issue

2

Start / End Page

266 / 273

Location

United States

Related Subject Headings

  • Retrospective Studies
  • North Carolina
  • Middle Aged
  • Male
  • Lupus Erythematosus, Systemic
  • Logistic Models
  • Humans
  • Female
  • Coronary Artery Disease
  • Coronary Angiography