Frailty is independently associated with subclinical cardiovascular disease in patients with systemic lupus erythematosus.

IF 5.1 2区 医学 Q1 RHEUMATOLOGY RMD Open Pub Date : 2024-09-23 DOI:10.1136/rmdopen-2024-004527
Maria Pappa, Kyriaki Keramiotou, Petros P Sfikakis, Maria G Tektonidou
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Abstract

Objectives: Cardiovascular disease is a leading cause of mortality in systemic lupus erythematosus (SLE). Frailty has been associated with an increased cardiovascular disease risk (CVR) in the general population. We aimed to examine the association between frailty and subclinical cardiovascular disease in patients with SLE.

Methods: In this cross-sectional study, we included all patients with SLE who underwent carotid/femoral artery ultrasound in our unit between 2016 and 2018. Clinical and laboratory data were collected at the time of ultrasound testing. Frailty was measured using the Systemic Lupus International Collaborating Clinics-Frailty Index (SLICC-FI). CVR (low, moderate, high, very high) was evaluated by the Systematic COronary Risk Evaluation (SCORE) model. Determinants of atherosclerotic plaque presence were assessed by logistic regression analyses, adjusting for potential confounders.

Results: 202 patients were included in the study. Atherosclerotic plaques (20.8% carotid, 17.3% femoral) were observed in 52/202 (25.7%) patients (89.1% women, mean (±SD) age 46.7±12.6). Median (IQR) SLICC-FI was 0.08 (0.04-0.10). 39 (19.3%) patients were classified as robust, 91 (45%) as relatively less fit, 59 (29.2%) as least fit and 13 (6.4%) as frail. In univariate analysis, plaque presence was significantly associated with age, disease duration, smoking, hypertension, systolic blood pressure, dyslipidaemia, SCORE, CVR class and SLICC-FI. CVR class (OR 5.16, p=0.000) and SLICC-FI (OR 1.34, p=0.03 per 0.05 point increase) remained significant in multivariate analysis after adjustment for traditional and disease-related CVR factors.

Conclusions: SLICC-FI is independently associated with plaque presence. Further studies are warranted to determine whether frailty-specific interventions can reduce CVR in patients with SLE.

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系统性红斑狼疮患者的虚弱与亚临床心血管疾病密切相关。
目的:心血管疾病是系统性红斑狼疮(SLE)患者死亡的主要原因。在一般人群中,虚弱与心血管疾病风险(CVR)的增加有关。我们旨在研究系统性红斑狼疮患者的虚弱与亚临床心血管疾病之间的关系:在这项横断面研究中,我们纳入了2016年至2018年间在本单位接受颈动脉/股动脉超声检查的所有系统性红斑狼疮患者。超声检查时收集临床和实验室数据。虚弱程度采用系统性红斑狼疮国际合作诊所-虚弱指数(SLICC-FI)进行测量。CVR(低、中、高、极高)通过系统性冠状动脉风险评估(SCORE)模型进行评估。通过逻辑回归分析评估了动脉粥样硬化斑块存在的决定因素,并对潜在的混杂因素进行了调整。52/202(25.7%)名患者(89.1%为女性,平均(±SD)年龄为46.7±12.6)观察到动脉粥样硬化斑块(20.8%为颈动脉斑块,17.3%为股动脉斑块)。SLICC-FI 中位数(IQR)为 0.08(0.04-0.10)。39(19.3%)名患者体格健壮,91(45%)名患者体格相对较差,59(29.2%)名患者体格最差,13(6.4%)名患者体质虚弱。在单变量分析中,斑块的存在与年龄、病程、吸烟、高血压、收缩压、血脂异常、SCORE、CVR 分级和 SLICC-FI 显著相关。CVR等级(OR 5.16,P=0.000)和SLICC-FI(OR 1.34,每增加0.05点,P=0.03)在调整了传统和疾病相关的CVR因素后,在多变量分析中仍具有显著性:结论:SLICC-FI与斑块的存在有独立关联。结论:SLICC-FI 与斑块的存在有独立的关联,需要进一步研究以确定针对虚弱的干预措施能否降低系统性红斑狼疮患者的 CVR。
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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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