原创力文档risk factors for cardiovascular mortality in patients with systemic lupus erythematosus, a prospective cohort study风险因素在系统性红斑狼疮患者心血管死亡率,前瞻性队列研究.pdfVIP
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risk factors for cardiovascular mortality in patients with systemic lupus erythematosus, a prospective cohort study风险因素在系统性红斑狼疮患者心血管死亡率,前瞻性队列研究
Gustafsson et al. Arthritis Research Therapy 2012, 14:R46
/content/14/2/R46
RESEARCH ARTICLE Open Access
Risk factors for cardiovascular mortality in
patients with systemic lupus erythematosus,
a prospective cohort study
1* 2 1 3 1 4
Johanna T Gustafsson , Julia F Simard , Iva Gunnarsson , Kerstin Elvin , Ingrid E Lundberg , Lars-Olof Hansson ,
Anders Larsson5 and Elisabet Svenungsson1
Abstract
Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Cardiovascular disease (CVD) is
common and a major cause of mortality. Studies on cardiovascular morbidity are abundant, whereas mortality
studies focusing on cardiovascular outcomes are scarce. The aim of this study was to investigate causes of death
and baseline predictors of overall (OM), non-vascular (N-VM), and specifically cardiovascular (CVM) mortality in SLE,
and to evaluate systematic coronary risk evaluation (SCORE).
Methods: 208 SLE patients were included 1995-1999 and followed up after 12 years. Clinical evaluation, CVD risk
factors, and biomarkers were recorded at inclusion. Death certificates and autopsy protocols were collected. Causes
of death were divided into CVM (ischemic vascular and general atherosclerotic diseases), N-VM and death due to
pulmonary hypertension. Predictors of mortality were investigated using multivariable Cox regression. SCORE and
standardized mortality ratio (SMR) were calculated.
Results: During follow-up 42 patients died at mean age of 62 years. SMR 2.4 (CI 1.7-3.0). 48% of deaths were
caused by CVM. SCORE underestimated CVM but not to a significant level. Age, high cystatin C levels and
established arterial disease were the strongest predictors for all- cause mortality
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