Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, 3500 Terrace Street, Pittsburgh, PA 15213, USA.
Circ Cardiovasc Interv. 2008 Dec;1(3):201-8. doi: 10.1161/CIRCINTERVENTIONS.108.788745.
Women with systemic lupus erythematosus (SLE) have premature and accelerated atherosclerosis. Although percutaneous coronary intervention (PCI) is used frequently to treat coronary artery disease in SLE, little is known regarding PCI outcomes immediately after PCI and after discharge.
Baseline demographic, procedure-related, and adverse outcome data on consecutive patients undergoing PCI during 5 recruitment "waves" of the National Heart, Lung, and Blood Institute Dynamic Registry across 23 clinical centers were collected. SLE patients (n=28) were compared with non-SLE patients (n=3385). SLE patients were younger and more often female in comparison with non-SLE patients undergoing PCI. SLE patients were less likely than non-SLE patients to have hyperlipidemia but had a similar prevalence of hypertension, diabetes mellitus, and tobacco use. The prevalence of multivessel disease was similar between groups. Initial intervention success (by angiographic definition) was not significantly different between groups. At 1 year, SLE patients were more likely to experience a myocardial infarction (15.6% versus 4.8%, P=0.01) and more often required repeat PCI (31.3% versus 11.8%, P=0.009) than non-SLE patients, even after adjustment for important covariates.
SLE patients had significantly worse cardiovascular outcomes at 1 year than non-SLE patients. Even considering the small number of SLE patients, these differences were striking. Further study is warranted to explore other factors potentially accounting for this disparity, including SLE disease activity and duration, presence of hypercoagulable state, and immunosuppressive therapy.
患有系统性红斑狼疮（SLE）的女性会出现过早和加速的动脉粥样硬化。尽管经皮冠状动脉介入治疗（PCI）常用于治疗 SLE 患者的冠状动脉疾病，但对于 PCI 后即刻和出院后的 PCI 结果知之甚少。
在国家心肺血液研究所动态注册中心的 5 个连续招募“波”中，收集了在 23 个临床中心进行 PCI 的连续患者的基线人口统计学、与手术相关的不良结局数据。将 SLE 患者（n=28）与非 SLE 患者（n=3385）进行比较。与接受 PCI 的非 SLE 患者相比，SLE 患者更年轻且更常为女性。与非 SLE 患者相比，SLE 患者发生高脂血症的可能性较小，但高血压、糖尿病和吸烟的患病率相似。两组多血管疾病的患病率相似。两组之间初始介入成功（根据血管造影定义）没有显著差异。在 1 年时，SLE 患者更有可能经历心肌梗死（15.6%比 4.8%，P=0.01），并且更常需要再次 PCI（31.3%比 11.8%，P=0.009），即使在调整了重要协变量后也是如此。
与非 SLE 患者相比，SLE 患者在 1 年内的心血管结局明显更差。即使考虑到 SLE 患者的数量较少，这些差异也很明显。需要进一步研究来探讨可能导致这种差异的其他因素，包括 SLE 疾病活动度和持续时间、存在高凝状态和免疫抑制治疗。
