Hochman J, Urowitz M B, Ibañez D, Gladman D D
University of Toronto Lupus Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.
Lupus. 2009 Apr;18(4):313-7. doi: 10.1177/0961203308097475.
We sought to determine the impact of hormone replacement therapy (HRT) on the occurrence of coronary artery disease (CAD) in women with systemic lupus erythematosus (SLE). Women in the University of Toronto lupus database who had taken HRT with no history of CAD were compared with all post-menopausal female patients with no history of HRT or CAD. Chi-squared and t-tests were used to compare the risk factors of CAD and Kaplan-Meier curve, log rank test and proportional hazard model with time-dependent covariates were used to compare the time from entry into the clinic to occurrence of CAD. A total of 114 HRT-user patients with no history of CAD were compared with 227 post-menopausal non-HRT user SLE controls. The groups were similar with respect to lupus anticoagulant, antiphospholipid antibody, cumulative steroid dose and classic cardiac risk factors. A similar percentage of patients developed CAD in the control (13.7%) and HRT (11.4%) groups. There was no difference in the time to development of CAD. In the multivariate analysis, HRT was not a risk factor for CAD. Only age (P = 0.0001, HR = 1.11, 95% CI = 1.05, 1.17) and SLEDAI-2K (P = 0.0001, HR = 1.10, 95% CI = 1.05, 1.16) were significantly associated with the risk of CAD. In this small group of patients with SLE, HRT alone did not appear to predispose to CAD.
我们试图确定激素替代疗法（HRT）对系统性红斑狼疮（SLE）女性冠心病（CAD）发生情况的影响。将多伦多大学狼疮数据库中接受过HRT且无CAD病史的女性与所有无HRT或CAD病史的绝经后女性患者进行比较。采用卡方检验和t检验比较CAD的危险因素，采用Kaplan-Meier曲线、对数秩检验以及带有时间依存性协变量的比例风险模型比较从进入诊所到发生CAD的时间。共有114例无CAD病史的HRT使用者患者与227例绝经后非HRT使用者SLE对照者进行了比较。两组在狼疮抗凝物、抗磷脂抗体、累积类固醇剂量以及经典心脏危险因素方面相似。对照组（13.7%）和HRT组（11.4%）发生CAD的患者比例相似。CAD发生时间无差异。在多变量分析中，HRT不是CAD的危险因素。只有年龄（P = 0.0001，HR = 1.11，95%CI = 1.05，1.17）和SLEDAI-2K（P = 0.0001，HR = 1.10，95%CI = 1.05，1.16）与CAD风险显著相关。在这一小群SLE患者中，单独使用HRT似乎不会增加CAD的易感性。
