Research Summary

Increased Cardiovascular Risk in Patients With Systemic Lupus Erythematosus and Lupus Nephritis

Jessica Ganga

Patients with systemic lupus erythematosus (SLE) who also have lupus nephritis (LN) face more cardiovascular (CV) risks compared with those with SLE alone, according to a systematic review and meta-analysis.

For their study, researchers utilized major databases including PubMed, EMBASE, MEDLINE, and Scopus where they identified studies between 1947 and 2022 that assessed cardiovascular risk factors and complications in patients with SLE, with or without LN.

The analysis included 22 two-arm studies (n = 8675) for a two-arm meta-analysis, and 45 studies (n = 385,315) for a proportional meta-analysis. The primary outcomes evaluated included the odds ratios (OR) for hypertension, hyperlipidemia, diabetes mellitus, myocardial infarction, cerebrovascular accident (CVA), and cardiovascular mortality.

Patients with SLE and LN had higher odds of developing hypertension (OR = 4.93, 95% CI, 3.17 to 7.65, P < 0.00001), hyperlipidemia (OR = 11.03, 95% CI, 4.20 to 28.95, P < 0.00001), and diabetes (OR = 1.88, 95% CI, 1.09 to 3.25, P = 0.02) compared with those without LN. Patients diagnosed with LN showed numerically higher prevalence of myocardial infarction (OR = 1.35, 95% CI, 0.53 to 3.45, P = 0.52) and cerebrovascular accident (OR = 1.64, 95% CI, 0.79 to 3.39, P = 0.27), than patients with SLE. Additionally, the incidence of cardiovascular mortality was higher in patients with LN, with 11.7 deaths per 1000 patient-years, compared with 3.6 per 1,000 patient-years in those without LN.

"Patients with SLE with LN show increased risk of CV risk factors including [diabetes mellitus], hypertension, and hyperlipidemia,” the authors concluded. “Early identification and optimal control of these CV risk factors may reduce the risk of CV disease and other non-CV complications.”

 

Reference:

Wong CY, Ma BMY, Zhang D, Cheung W, Chan TM, Yap DYH. Cardiovascular risk factors and complications in patients with systemic lupus erythematosus with and without nephritis: a systematic review and meta-analysis. Lupus Sci Med. Published online March 21, 2024. doi:10.1136/lupus-2024-001152