Levinson Dennis J, Abugroun Ashraf, Daoud Hussein, Abdel-Rahman Manar
University of Illinois, Chicago, IL, USA.
Medical College of Wisconsin, WI, USA.
Int J Cardiol Hypertens. 2020 Oct 14;7:100056. doi: 10.1016/j.ijchy.2020.100056. eCollection 2020 Dec.
Patients with systemic lupus erythematosus (SLE) are at higher risk for coronary artery disease (CAD) particularly at a younger age. We sought to determine the effect of risk factors on the prevalence of CAD in age stratified hospitalized patients with SLE.
The National Inpatient Sample (NIS) was queried for hospitalized patients with SLE during the years 2010-2015, and a control group without SLE. The study sample was stratified by age, 18-35 years, 36-55 years, and adults >55 years. The effect of SLE and traditional Framingham risk factors on the prevalence of CAD were assessed. Dominance analysis allowed for ranking of CAD risk factors in each age group.
A total 167,466 patients were matched to an equal number of controls. 88.8% were women, 48.5% Caucasian and 29% African-American. In lupus patients 18-35 years prevalent risk factors included hyperlipidemia, hypertension, hypercoagulability and CKD. Diabetes and depression ranked least important. In middle and older patients, traditional risk factors were dominant. In adults >55 years the prevalence of CAD appears higher in Caucasians whereas in young patients 18-35 years, African Americans are dominant.
CAD in the young adult patient with SLE is represented predominately by an African-American population and it is dominated by a hypercoagulable state and a less significant role for diabetes. In the lupus cohort over 55 years, which is predominantly Caucasian, SLE specific factors are less significant.
系统性红斑狼疮（SLE）患者患冠状动脉疾病（CAD）的风险更高，尤其是在较年轻的时候。我们试图确定风险因素对年龄分层的住院SLE患者CAD患病率的影响。
查询2010 - 2015年期间全国住院患者样本（NIS）中住院的SLE患者以及一个无SLE的对照组。研究样本按年龄分层，分为18 - 35岁、36 - 55岁和大于55岁的成年人。评估SLE和传统弗明汉风险因素对CAD患病率的影响。优势分析用于对各年龄组的CAD风险因素进行排名。
总共167,466名患者与同等数量的对照组相匹配。88.8%为女性，48.5%为白种人，29%为非裔美国人。在18 - 35岁的狼疮患者中，常见的风险因素包括高脂血症、高血压、高凝状态和慢性肾脏病。糖尿病和抑郁症的重要性最低。在中年和老年患者中，传统风险因素占主导。在大于55岁的成年人中，白种人的CAD患病率似乎更高，而在18 - 35岁的年轻患者中，非裔美国人占主导。
年轻成年SLE患者中的CAD主要以非裔美国人为主，其主要由高凝状态主导，糖尿病的作用较小。在主要为白种人的55岁以上狼疮队列中，SLE特异性因素的重要性较低。
