Age-specific Incidence Rates of Myocardial Infarction and Angina in Women With Systemic Lupus Erythematosus: Comparison With the Framingham Study
Susan Manzi,Elaine N. Meilahn,Joan E. Rairie,Claudia Conte,Thomas A. Medsger,Linda Jansen-McWilliams,Ralph B. D'Agostino,Lewis H. Kuller +7 more
TLDR
Women with lupus in the 35- to 44-year age group were over 50 times more likely to have a myocardial infarction than were women of similar age in the Framingham Offspring Study.Abstract:
The authors ascertained cardiovascular events (myocardial infarction and angina pectoris) in 498 women with systemic lupus erythematosus seen at the University of Pittsburgh Medical Center from 1980 to 1993 (3,522 person-years). Subjects were stratified by age, and cardiovascular event incidence rates were determined. The authors compared these rates with cardiovascular event rates were determined. The authors compared these rates with cardiovascular event rates occurring over the same time period in 2,208 women of similar age participating in the Framingham Offspring Study (17,519 person-years). Age-specific rate ratios were computed to determine whether the cardiovascular events in the lupus cohort were greater than expected. The risk factors associated with cardiovascular events in women with lupus were determined. There were 33 first events (11 myocardial infarction, 10 angina pectoris, and 12 both angina pectoris and myocardial infarction) after the diagnosis of lupus: two thirds were under the age of 55 years at the time of event. Women with lupus in the 35- to 44-year age group were over 50 times more likely to have a myocardial infarction than were women of similar age in the Framingham Offspring Study (rate ratio = 52.43, 95% confidence interval 21.6-98.5). Older age at lupus diagnosis, longer lupus disease duration, longer duration of corticosteroid use, hypercholesterolemia, and postmenopausal status were more common in the women with lupus who had a cardiovascular event than in those who did not have an event. Premature cardiovascular disease is much more common in young premenopausal women with lupus than in a population sample. With the increased life expectancy of lupus patients due to improved therapy, cardiovascular disease has emerged as a significant threat to the health of these women. The impact of this problem has been underrecognized, with little focus placed on aggressive management of hypercholesterolemia and other possible risk factors.read more
Citations
More filters
Journal ArticleDOI
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
Donna K. Arnett,Roger S. Blumenthal,Michelle A. Albert,Andrew B. Buroker,Zachary D. Goldberger,Ellen J. Hahn,Cheryl Dennison Himmelfarb,Amit Khera,Donald M. Lloyd-Jones,J. William McEvoy,Erin D. Michos,Michael D. Miedema,Daniel Muñoz,Sidney C. Smith,Salim S. Virani,Kim A. Williams,Joseph Yeboah,Boback Ziaeian +17 more
TL;DR: Patrick T. O’Gara, MD, MACC, FAHA, Chair Joshua A. Beckman,MD, MS, FAha, Chair-Elect Glenn N. Levine, MD., Immediate Past Chair Sana M. Al-Khatib, MD.
Journal ArticleDOI
2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons.
Stephan D. Fihn,Julius M. Gardin,Jonathan Abrams,Kathleen Berra,James C. Blankenship,Apostolos P. Dallas,Pamela S. Douglas,JoAnne M. Foody,Thomas C. Gerber,Alan L. Hinderliter,Spencer B. King,Paul Kligfield,Harlan M. Krumholz,Raymond Y. Kwong,Michael J. Lim,Jane A. Linderbaum,Michael J. Mack,Mark A. Munger,Richard L. Prager,Joseph F. Sabik,Leslee J. Shaw,Joanna D. Sikkema,Craig R. Smith,Sidney C. Smith,John A. Spertus,Sankey V. Williams +25 more
TL;DR: A Report of the American College of Cardiology Foundation/AmericanHeart Association Task Force on Practice Guidelines, and the AmericanCollege of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for CardiovascularAngiography and Interventions, and Society of ThorACic Surgeons
Journal ArticleDOI
Medical-eligibility criteria for contraceptive use.
TL;DR: The revised version of the WHO document on medical eligibility criteria for contraceptive use aims to ensure that contraceptive counseling is based on the best available evidence and to simplify the criteria for eligibility to include only those essential for screening to ensure the safe provision of contraceptive services.
Journal ArticleDOI
Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus
Mary J. Roman,Beth-Ann Shanker,Adrienne Davis,Michael D. Lockshin,Lisa R. Sammaritano,Ronit Simantov,Mary K. Crow,Joseph E. Schwartz,Stephen A. Paget,Richard B. Devereux,Jane E. Salmon +10 more
TL;DR: The clinical profile of patients with lupus and atherosclerosis suggests a role for disease-related factors in atherogenesis and underscores the need for trials of more focused and effective antiinflammatory therapy.
Journal ArticleDOI
High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors
TL;DR: The increased incidence of CV events in RA patients is independent of traditional CV risk factors, which suggests that additional mechanisms are responsible for CV disease in RA.
References
More filters
Journal ArticleDOI
The 1982 revised criteria for the classification of systemic lupus erythematosus
Eng M. Tan,Alan S. Cohen,James F. Fries,Alfonse T. Masi,Dennis J. McShane,Naomi F. Rothfield,Jane G. Schaller,Norman Talal,Robert Winchester +8 more
TL;DR: The 1971 preliminary criteria for the classification of systemic lupus erythematosus (SLE) were revised and updated to incorporate new immunologic knowledge and improve disease classification and showed gains in sensitivity and specificity.
Journal ArticleDOI
The cardiovascular health study: Design and rationale
Linda P. Fried,Nemat O. Borhani,Paul L. Enright,Curt D. Furberg,Julius M. Gardin,Richard A. Kronmal,Lewis H. Kuller,Teri A. Manolio,Maurice B. Mittelmark,Anne B. Newman,Daniel H. O'Leary,Bruce M. Psaty,Pentti M. Rautaharju,Russell P. Tracy,Philip G. Weiler +14 more
TL;DR: These examinations in CHS permit evaluation of CVD risk factors in older adults, particularly in groups previously under-represented in epidemiologic studies, such as women and the very old.
Journal ArticleDOI
An investigation of coronary heart disease in families the framingham offspring study
William B. Kannel,Manning Feinleib,Patricia M. McNamara,Robert J. Garrison,William P. Castelli +4 more
TL;DR: There is little evidence that coronary heart disease (CHD) experience and CHD risk factors differ in parents of those who volunteered for this study and the parents ofThose who did not volunteer.
Journal ArticleDOI
The bimodal mortality pattern of systemic lupus erythematosus
Murray B. Urowitz,Arthur Bookman,Barry E. Koehler,Duncan A. Gordon,Hugh A. Smythe,Metro A. Ogryzlo +5 more
TL;DR: An examination of the deaths in a long-term systematic analysis of 81 patients followed for five years at the University of Toronto Rheumatic Disease Unit found death is associated with inactive lupus, long duration of steroid therapy and a striking incidence of myocardial infarction due to atherosclerotic heart disease.
Journal ArticleDOI
Surveillance and ascertainment of cardiovascular events: The Cardiovascular Health Study☆
Diane G. Ives,Annette L. Fitzpatrick,Diane E. Bild,Bruce M. Psaty,Lewis H. Kuller,Patricia Crowley,R.Gale Cruise,Sharene Theroux +7 more
TL;DR: The CHS techniques are a successful model for complete ascertainment, investigation, and documentation of events in an older cohort.