Assessment of the cardiovascular risk in patients with systemic lupus erythematosus: choosing the appropriate tool

Abstract

Abstract Objectives. The aim of the research was to assess the cardiovascular risk in patients with systemic lupus erythematosus (SLE). Materials and Methods. Cross-sectional study, including 96 patients with Systemic Lupus Erythematosus (The Systemic Lupus Collaborating Clinics classification criteria, 2012), was conducted at the Department of Internal Medicine, Institute of Cardiology, Chișinău, Republic of Moldova, between 2017-2019 years. We calculated and compared the 10-year cardiovascular risk by Systemic Coronary Risk Evaluation versus Systemic Lupus Erythematosus cardiovascular risk equation. Results. A total number of 96 patients were included in the study, with female gender predominance (92 patients, 96%) and mean age, at the moment of the study, of 43.2±12.1 years. The Systemic Lupus Erythematosus duration was 89,9±44,1 months. The disease activity by Systemic Lupus Erythematosus Disease Activity Index was 8.08±7,1 points. Traditional cardiovascular risk factors were hypertension (50%), age (16.6%) and hypercholesterolemia (12.5%). Non-traditional risk factors were high disease activity (33.3%), antiphospholipid syndrome (33.3%), and renal lupus (20.8%). The mean 10-year risk provided by Systemic Coronary Risk Evaluation was 7.8±9.0 points. Overall, 12.5% of participants were deemed high risk, most of the subjects having moderate 45.8% or low 41.7% cardiovascular risk. According to Systemic Lupus Erythematosus Cardiovascular Risk Equation, we have established that 29.1% of patients had high cardiovascular risk, compared to only 12.5% by Systemic Coronary Risk Evaluation (p<0.05). Conclusion. Patients with Systemic Lupus Erythematosus have a high cardiovascular risk, by combining traditional and non-traditional risk factors (disease activity, lupus nephritis, and antiphospholipid syndrome). For clinical use, the specific tool for stratifying cardiovascular risk in Systemic Lupus Erythematosus is recommended.