University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Division of Rheumatology, University of Toronto, Toronto, Canada.
J Rheumatol. 2009 Nov;36(11):2454-61. doi: 10.3899/jrheum.090011. Epub 2009 Oct 15.
To ascertain coronary artery disease (CAD) outcomes and predictive factors in a prospective study of patients with systemic lupus erythematosus (SLE) and matched healthy controls.
SLE patients and non-SLE age-matched controls without a history of CAD were recruited into a prospective study between 1997 and 1999. CAD events were assessed at clinic visit for SLE patients and through telephone interview and chart review for controls. All events were verified with patient medical records.
Followup information was available on 237 controls and 241 SLE patients. The mean followup time was 7.2 years. Univariate analyses identified age and postmenopausal status as predictors of CAD in both the groups. Sedentary lifestyle, hypertension, the presence of metabolic syndrome, and the number of Framingham risk factors were predictive in the control group only. The 10-year risk of CAD score was predictive in both groups but was not as marked in the SLE group as in the controls. None of the lipid subfractions were predictive for CAD in the SLE group, whereas in the controls, a high triglyceride level >or= 2.8 was predictive. Time-to-event multivariate analysis for CAD in all subjects revealed SLE itself, older age, and triglycerides >or= 2.8 to be highly predictive for CAD.
In a prospective study of patients with SLE and matched controls followed over a median of 8 years, patients with SLE developed significantly more CAD events than controls. Accounting for demographic variability, CAD risk factors, and lipid factors, SLE is an independent risk factor for the development of CAD.
通过一项对系统性红斑狼疮（SLE）患者和匹配健康对照者的前瞻性研究，明确冠状动脉疾病（CAD）的结局和预测因素。
1997 年至 1999 年期间，我们对 SLE 患者和无 CAD 病史且年龄匹配的非 SLE 对照者进行了前瞻性研究，招募了这些患者和对照者。通过对 SLE 患者进行临床访视，对对照者进行电话访谈和病历回顾来评估 CAD 事件。所有事件均通过患者病历进行了确认。
对 237 名对照者和 241 名 SLE 患者进行了随访信息评估。平均随访时间为 7.2 年。单变量分析确定年龄和绝经后状态是两组中 CAD 的预测因素。在对照组中，久坐的生活方式、高血压、代谢综合征的存在和Framingham 风险因素的数量是 CAD 的预测因素。10 年 CAD 风险评分在两组中均具有预测性，但在 SLE 组中的预测性不如对照组中明显。在 SLE 组中，没有血脂亚组分对 CAD 具有预测性，而在对照组中，甘油三酯水平 >或= 2.8 是预测性的。对所有受试者的 CAD 时间事件多变量分析显示，SLE 本身、年龄较大和甘油三酯 >或= 2.8 是 CAD 的高度预测因素。
在一项对 SLE 患者和匹配对照者的前瞻性研究中，中位随访 8 年以上，SLE 患者发生的 CAD 事件明显多于对照者。考虑到人口统计学变异性、CAD 危险因素和脂质因素，SLE 是 CAD 发生的独立危险因素。
