Remission, Attaining CV Risk Targets Drops CVD Risk in Lupus

Medscape

2 days ago

Patients with systemic lupus erythematosus (SLE) had more than double the risk for atherosclerosis progression over 10 years than healthy control individuals, but maintaining cardiovascular risk factor (CVRF) targets and achieving sustained disease remission significantly reduced this risk.
METHODOLOGY:
Researchers collected carotid ultrasound measurements from 111 patients with SLE and 94 age- and sex-matched controls, including baseline measurements from 2012 to 2013 with follow-up assessments at 3, 7, and 10 years.
They tracked carotid plaque progression, CVRF target attainment on the basis of the 2016 European Society of Cardiology Guidelines on cardiovascular disease (CVD) prevention and additional CVD risk modifiers, and incident CVD events over 10 years and looked for predictors of plaque progression.
TAKEAWAY:
Patients with SLE demonstrated a 2.3-fold higher risk for carotid plaque progression than healthy control individuals (incidence rate ratio [IRR], 2.26; 95% CI, 1.34-3.81; P = .002).
= .002). Each CVRF maintained at target during the 10-year follow-up reduced plaque progression risk by 32% (IRR, 0.68; 95% CI, 0.53-0.89; P = .004).
= .004). Achievement of definition of remission in SLE for ≥ 75% of follow-up decreased risk for plaque progression by 43% (IRR, 0.57; 95% CI, 0.34-0.95; P = .033).
= .033). Persistent triple antiphospholipid antibody positivity increased 10-year risk for incident cardiovascular events in SLE more than sevenfold (hazard ratio, 7.52; P = .014).
IN PRACTICE:
'Patients with SLE experience a 2.3-fold higher 10-year atherosclerosis progression risk than [healthy controls], which is significantly mitigated by sustained [cardiovascular risk factor] control and prolonged clinical remission,' the study authors wrote in the abstract. 'Carotid ultrasound may have an additive role in enhancing CVD risk assessment in patients with SLE.'
SOURCE:
Maria G. Tektonidou, MD, PhD, of the National and Kapodistrian University of Athens, Athens, Greece, presented the study at the 16th International Congress on Systemic Lupus Erythematosus in Toronto.
LIMITATIONS:
The study sample was relatively small. Carotid ultrasound is dependent on operator skill and experience, which can lead to interobserver and intraobserver variability.
DISCLOSURES:
Funding information for this research was not provided. Disclosure information for the authors was not available.