Ibrahim Almaghlouth, Kawther Ghassan Bohuliga, Boshra Alanazi, Bushra Khaled Alhawsa, Abdulaziz Mohammed Alabdulkareem, Wael Alqarawi, Kazi Nur Asfina, Najma Khalil, Hebatallah Hamed Ali, Mohammed Bedaiwi, Aos Aboabat, Jiandong Su, Tariq Asef Alam, Fehaid Ghali Alanazi, Mohammed A Omair, Abdurhman S Alarfaj, Haya M Almalag, Mostafa Al Shamiri, Khalid F Alhabib
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The study used two datasets, namely the Saudi national prospective cohort for SLE patients and the Prospective Urban-Rural Epidemiology Study Saudi subcohort (PURE-Saudi) for the general population. Participants in both studies were monitored using a standardised protocol. MACE was defined as myocardial infarction (MI), stroke or angina. The analysis was adjusted for demographics, traditional cardiovascular risk factors and SLE diagnosis through logistic regression models.</p><p><strong>Results: </strong>The PURE and national SLE cohorts comprised 488 and 746 patients, respectively. Patients with SLE from the SLE cohort were younger (40.7±12.5 vs 49.5±8.6 years) and predominantly female (90.6% vs 41.6%). The prevalence of traditional risk factors was greater in the PURE cohort compared with the SLE cohort. These factors included dyslipidaemia (28.9% vs 49.4%), obesity (63% vs 85%) and diabetes (7.8% vs 27.2%), but not hypertension (19.3% vs 18.8%). MACE (defined as MI or stroke or venous thromboembolism or heart failure) occurred more frequently in patients with SLE (4.3% vs 1.6%, p=0.004). Older age and lupus diagnosis were independently associated with MACE after adjusting for conventional risk factors. The odds of MACE were significantly related to age and lupus diagnosis (p=0.00 and p=0.00, respectively), but not cardiovascular disease (CVD) risk factors (p=0.83).</p><p><strong>Conclusion: </strong>Patients with SLE have a significantly higher risk of developing MACE than the general population. This risk is not well explained by traditional risk factors, which may explain the failure of CVD risk scores to stratify patients with SLE adequately. 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引用次数: 0
摘要
目的：本研究调查了沙特系统性红斑狼疮患者和普通人群中主要心血管不良事件（MACE）的发生率，并考虑了与此类结果相关的因素：本研究调查了沙特系统性红斑狼疮患者和普通人群中主要不良心血管事件（MACE）的发生率，并考虑了与此类结果相关的因素：这是一项队列研究，评估了 2020 年至 2023 年期间 MACE 的发生率。该研究使用了两个数据集，即针对系统性红斑狼疮患者的沙特国家前瞻性队列和针对普通人群的沙特城乡流行病学前瞻性研究沙特子队列（PURE-Saudi）。这两项研究的参与者都接受了标准化方案的监测。MACE定义为心肌梗死（MI）、中风或心绞痛。分析结果通过逻辑回归模型对人口统计学、传统心血管风险因素和系统性红斑狼疮诊断进行了调整：PURE 和全国系统性红斑狼疮队列中分别有 488 名和 746 名患者。系统性红斑狼疮队列中的系统性红斑狼疮患者更年轻（40.7±12.5 岁 vs 49.5±8.6岁），以女性为主（90.6% vs 41.6%）。与系统性红斑狼疮队列相比，PURE 队列中传统风险因素的发生率更高。这些因素包括血脂异常（28.9% 对 49.4%）、肥胖（63% 对 85%）和糖尿病（7.8% 对 27.2%），但不包括高血压（19.3% 对 18.8%）。系统性红斑狼疮患者的MACE（定义为心肌梗死或中风或静脉血栓栓塞或心力衰竭）发生率更高（4.3% vs 1.6%，P=0.004）。在对常规风险因素进行调整后，高龄和狼疮诊断与MACE独立相关。MACE的几率与年龄和狼疮诊断有明显关系（分别为p=0.00和p=0.00），但与心血管疾病（CVD）风险因素无关（p=0.83）：结论：系统性红斑狼疮患者发生MACE的风险明显高于普通人群。结论：系统性红斑狼疮患者罹患MACE的风险明显高于普通人群，而传统的风险因素并不能很好地解释这种风险，这可能是心血管疾病风险评分未能对系统性红斑狼疮患者进行充分分层的原因。要了解系统性红斑狼疮患者心血管疾病风险的发病机理并降低其风险，还需要进一步的研究。
Prevalence of major adverse cardiovascular events among Saudi patients with systemic lupus erythematosus compared with the general population: updates from the national SLE and PURE cohorts.
Objective: This study examined the prevalence of major adverse cardiovascular events (MACE) among Saudi patients with SLE and the general population and considered factors associated with such outcomes were taken into consideration.
Methods: This is a cohort study evaluating the period prevalence of MACE from 2020 to 2023. The study used two datasets, namely the Saudi national prospective cohort for SLE patients and the Prospective Urban-Rural Epidemiology Study Saudi subcohort (PURE-Saudi) for the general population. Participants in both studies were monitored using a standardised protocol. MACE was defined as myocardial infarction (MI), stroke or angina. The analysis was adjusted for demographics, traditional cardiovascular risk factors and SLE diagnosis through logistic regression models.
Results: The PURE and national SLE cohorts comprised 488 and 746 patients, respectively. Patients with SLE from the SLE cohort were younger (40.7±12.5 vs 49.5±8.6 years) and predominantly female (90.6% vs 41.6%). The prevalence of traditional risk factors was greater in the PURE cohort compared with the SLE cohort. These factors included dyslipidaemia (28.9% vs 49.4%), obesity (63% vs 85%) and diabetes (7.8% vs 27.2%), but not hypertension (19.3% vs 18.8%). MACE (defined as MI or stroke or venous thromboembolism or heart failure) occurred more frequently in patients with SLE (4.3% vs 1.6%, p=0.004). Older age and lupus diagnosis were independently associated with MACE after adjusting for conventional risk factors. The odds of MACE were significantly related to age and lupus diagnosis (p=0.00 and p=0.00, respectively), but not cardiovascular disease (CVD) risk factors (p=0.83).
Conclusion: Patients with SLE have a significantly higher risk of developing MACE than the general population. This risk is not well explained by traditional risk factors, which may explain the failure of CVD risk scores to stratify patients with SLE adequately. Further studies are needed to understand CVD risk's pathogenesis in SLE and mitigate it.
期刊介绍：
Lupus Science & Medicine is a global, peer reviewed, open access online journal that provides a central point for publication of basic, clinical, translational, and epidemiological studies of all aspects of lupus and related diseases. It is the first lupus-specific open access journal in the world and was developed in response to the need for a barrier-free forum for publication of groundbreaking studies in lupus. The journal publishes research on lupus from fields including, but not limited to: rheumatology, dermatology, nephrology, immunology, pediatrics, cardiology, hepatology, pulmonology, obstetrics and gynecology, and psychiatry.
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