Factors associated with arterial vascular events in PROFILE

A multiethnic lupus cohort

A. M. Bertoli, Luis M. Vilá, G. S. Alarcón, G. McGwin, J. C. Edberg, Michelle Petri, R. Ramsey-Goldman, J. D. Reveille, R. P. Kimberly

Research output: Contribution to journalArticle

Abstract

The objective of this study was to determine the factors associated with the occurrence of arterial vascular events in a multiethnic systemic lupus erythematosus (SLE) cohort. The PROFILE cohort, comprised SLE patients (n = 1333) of defined ethnicity from five different US institutions, was studied to determine demographic, clinical and biological variables associated with vascular events. An arterial vascular event (first episode) was either a myocardial infarction, angina pectoris and/or a vascular procedure for myocardial infarction, stroke, claudication and/or evidence of gangrene. Patient characteristics were analyzed by univariable and multivariable Cox proportional hazards regression analyses. One-hundred twenty-three (9.8%) patients had at least one incident arterial event. Age at cohort enrollment (HR = 1.04, 95% CI 1.03-1.06), smoking (HR = 2.20, 95% CI 1.40-3.46) and the CRP2* C alleles (HR = 1.91, 95% CI 1.04-3.49) were associated with a shorter time-to-the occurrence of arterial vascular events. Some clinical manifestations of disease activity were associated with a shorter time-to-occurrence [psychosis (HR = 2.21, 95% CI 1.10-4.44), seizures (HR = 1.85, 95% CI 1.00-3.24) and anaemia (HR = 1.83, 95% CI 1.02-3.31)], but others were not [arthritis (HR = 0.32, 95% CI 0.18-0.58)]. In conclusion, older patients, especially in the context of a predisposing environmental factor (smoking) and severe clinical manifestations, are at higher risk of having arterial vascular events. The genetic contribution of the variation at the CRP locus was not obscured by demographic or clinical variables. Awareness of these factors should lead to more effective management strategies of patients at risk for arterial vascular events.

Original languageEnglish (US)
Pages (from-to)958-965
Number of pages8
JournalLupus
Volume18
Issue number11
DOIs
StatePublished - 2009

Fingerprint

Blood Vessels
Systemic Lupus Erythematosus
Smoking
Myocardial Infarction
Demography
Gangrene
Angina Pectoris
Causality
Psychotic Disorders
Arthritis
Anemia
Seizures
Stroke
Alleles
Regression Analysis

Keywords

  • Cardiovascular disease
  • Systemic lupus erythematosus
  • Thrombosis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Bertoli, A. M., Vilá, L. M., Alarcón, G. S., McGwin, G., Edberg, J. C., Petri, M., ... Kimberly, R. P. (2009). Factors associated with arterial vascular events in PROFILE: A multiethnic lupus cohort. Lupus, 18(11), 958-965. https://doi.org/10.1177/0961203309104862

Factors associated with arterial vascular events in PROFILE : A multiethnic lupus cohort. / Bertoli, A. M.; Vilá, Luis M.; Alarcón, G. S.; McGwin, G.; Edberg, J. C.; Petri, Michelle; Ramsey-Goldman, R.; Reveille, J. D.; Kimberly, R. P.

In: Lupus, Vol. 18, No. 11, 2009, p. 958-965.

Research output: Contribution to journalArticle

Bertoli, AM, Vilá, LM, Alarcón, GS, McGwin, G, Edberg, JC, Petri, M, Ramsey-Goldman, R, Reveille, JD & Kimberly, RP 2009, 'Factors associated with arterial vascular events in PROFILE: A multiethnic lupus cohort', Lupus, vol. 18, no. 11, pp. 958-965. https://doi.org/10.1177/0961203309104862
Bertoli, A. M. ; Vilá, Luis M. ; Alarcón, G. S. ; McGwin, G. ; Edberg, J. C. ; Petri, Michelle ; Ramsey-Goldman, R. ; Reveille, J. D. ; Kimberly, R. P. / Factors associated with arterial vascular events in PROFILE : A multiethnic lupus cohort. In: Lupus. 2009 ; Vol. 18, No. 11. pp. 958-965.
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abstract = "The objective of this study was to determine the factors associated with the occurrence of arterial vascular events in a multiethnic systemic lupus erythematosus (SLE) cohort. The PROFILE cohort, comprised SLE patients (n = 1333) of defined ethnicity from five different US institutions, was studied to determine demographic, clinical and biological variables associated with vascular events. An arterial vascular event (first episode) was either a myocardial infarction, angina pectoris and/or a vascular procedure for myocardial infarction, stroke, claudication and/or evidence of gangrene. Patient characteristics were analyzed by univariable and multivariable Cox proportional hazards regression analyses. One-hundred twenty-three (9.8{\%}) patients had at least one incident arterial event. Age at cohort enrollment (HR = 1.04, 95{\%} CI 1.03-1.06), smoking (HR = 2.20, 95{\%} CI 1.40-3.46) and the CRP2* C alleles (HR = 1.91, 95{\%} CI 1.04-3.49) were associated with a shorter time-to-the occurrence of arterial vascular events. Some clinical manifestations of disease activity were associated with a shorter time-to-occurrence [psychosis (HR = 2.21, 95{\%} CI 1.10-4.44), seizures (HR = 1.85, 95{\%} CI 1.00-3.24) and anaemia (HR = 1.83, 95{\%} CI 1.02-3.31)], but others were not [arthritis (HR = 0.32, 95{\%} CI 0.18-0.58)]. In conclusion, older patients, especially in the context of a predisposing environmental factor (smoking) and severe clinical manifestations, are at higher risk of having arterial vascular events. The genetic contribution of the variation at the CRP locus was not obscured by demographic or clinical variables. Awareness of these factors should lead to more effective management strategies of patients at risk for arterial vascular events.",
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AB - The objective of this study was to determine the factors associated with the occurrence of arterial vascular events in a multiethnic systemic lupus erythematosus (SLE) cohort. The PROFILE cohort, comprised SLE patients (n = 1333) of defined ethnicity from five different US institutions, was studied to determine demographic, clinical and biological variables associated with vascular events. An arterial vascular event (first episode) was either a myocardial infarction, angina pectoris and/or a vascular procedure for myocardial infarction, stroke, claudication and/or evidence of gangrene. Patient characteristics were analyzed by univariable and multivariable Cox proportional hazards regression analyses. One-hundred twenty-three (9.8%) patients had at least one incident arterial event. Age at cohort enrollment (HR = 1.04, 95% CI 1.03-1.06), smoking (HR = 2.20, 95% CI 1.40-3.46) and the CRP2* C alleles (HR = 1.91, 95% CI 1.04-3.49) were associated with a shorter time-to-the occurrence of arterial vascular events. Some clinical manifestations of disease activity were associated with a shorter time-to-occurrence [psychosis (HR = 2.21, 95% CI 1.10-4.44), seizures (HR = 1.85, 95% CI 1.00-3.24) and anaemia (HR = 1.83, 95% CI 1.02-3.31)], but others were not [arthritis (HR = 0.32, 95% CI 0.18-0.58)]. In conclusion, older patients, especially in the context of a predisposing environmental factor (smoking) and severe clinical manifestations, are at higher risk of having arterial vascular events. The genetic contribution of the variation at the CRP locus was not obscured by demographic or clinical variables. Awareness of these factors should lead to more effective management strategies of patients at risk for arterial vascular events.

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