Atherosclerotic Vascular Events in a Multinational Inception Cohort of Systemic Lupus Erythematosus

Objective. To describe vascular events during an 8-year followup in a multicenter systemic lupus erythematosus (SLE) inception cohort and their attribution to atherosclerosis. Methods. Clinical data, including comorbidities, were recorded yearly. Vascular events were recorded and attributed to atherosclerosis or not. All of the events met standard clinical criteria. Factors associated with atherosclerotic vascular events were analyzed using descriptive statistics, t-tests, and chi-square tests. Stepwise multivariate logistic regression was used to assess the association of factors with vascular events attributed to atherosclerosis. Results. Since 2000, 1,249 patients have been entered into the cohort. There have been 97 vascular events in 72 patients, including: myocardial infarction (n = 13), angina (n = 15), congestive heart failure (n = 24), peripheral vascular disease (n = 8), transient ischemic attack (n = 13), stroke (n = 23), and pacemaker insertion (n = 1). Fifty of the events were attributed to active lupus, 31 events in 2Dr. Urowitz's work was supported by the Canadian Institutes of Health Research (grant MOP-49529), the Lupus Foundation of Ontario, the Ontario Lupus Association, Lupus UK, the Lupus Foundation of America, the Lupus Alliance of Western New York, the Conn Smythe Foundation, The Lupus Flare Foundation, and the Tolfo family of Toronto, Ontario, Canada. Dr. Gladman's work was supported by the Canadian Institutes of Health Research. Dr. Bae's work was supported by the Brain Korea 21 Program. Dr. Gordon's work was supported by Lupus UK, the Arthritis Research Campaign, and the Wellcome Trust Clinical Research Facility, Birmingham, UK. Dr. Clarke's work was supported by the Singer Family Fund for Lupus Research, and is a Fonds de la Recherche en Sante du Quebec National Scholar. Dr. Bernatsky's work was supported by the Fonds de la Recherche en Sante du Quebec Jeune Chercheure and the McGill University Health Centre Research Institute, and is recipient of a Canadian Institutes of Health Research Junior Investigator Award and a Canadian Arthritis Network Scholar Award. Dr. Fortin is a Distinguished Senior Investigator of The Arthritis Society, with additional support from the Arthritis Centre of Excellence, University of Toronto. Dr. Hanly's work was supported by a grant from the Canadian Institutes of Health Research. Dr. Alarco'n's work was supported by the University of Alabama at Birmingham (NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases grant P60-AR-48095). Drs. Nived and Sturfelt's work was supported by the Swedish Medical Research Council (grant 13489). Dr. Ramsey-Goldman's work was supported by the NIH (grants UL-1RR-025741, K24-AR-02318, and P60-AR-48098). Dr. Petri's work was supported by the Hopkins Lupus Cohort (grant AR-43727) and the Johns Hopkins University General Clinical Research Center (grant M01-RR-00052)