Lupus Damage and Waist Circumference as the Independent
Risk Factors for Cardiovascular Disease in SLE Patients
from Phramongkutklao Hospital
Wittaya Siricheepchaiyan MD*, Pongthorn Narongroeknawin MD*,
Rattapon Pakchotanon MD*, Paijit Asavatanabodee MD*, Sumapa Chaiamnuay MD*
Affiliation :
* Rheumatic Disease Unit, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Background : Cardiovascular disease (CVD) has been reported to be a major cause of both morbidity and premature
mortality in systemic lupus erythematosus (SLE) patients.
Objective : To determine the prevalence of cardiovascular disease and associated risk factors in Thai SLE patients from
Phramongkutklao Hospital, Thailand.
Material and Method: A retrospective cross-sectional study was performed to investigate the frequency of CVD in SLE
patients in Phramongkutklao Hospital on the basis of medical record documentation. CVD was defined as coronary heart
disease, congestive heart failure, cerebrovascular disease (stroke), transient ischemic attack, and peripheral arterial disease
(PAD). The associated risk factors of CVD were examined by univariate and multivariate logistic regression analyses.
Results : One hundred fifty nine SLE patients were enrolled in the present study. Nine female and one male SLE patients had
CVD (prevalence 6.3%). SLE patients with CVD had higher Systemic Lupus International Collaborating Clinics Damage
Index (SDI) score (p-value = 0.025) and received higher average dose of corticosteroid (p-value = 0.034) than SLE patients
without CVD. Patients with CVD were more likely to present with malar rash (p-value = 0.054), discoid rash (p-value =
0.047), and more likely to used cyclophosphamide (p-value = 0.045) than patients without CVD. SLE patients with CVD
were more likely to have diabetes mellitus (p-value = 0.037), antiphospholipid syndrome (p-value = 0.055), and had higher
proportion of patients whose waist circumference more than 90 centimeters in male or more than 80 centimeters in female
(p-value = 0.06) than SLE patients without CVD. The presence of antiphospholipid antibodies was higher in SLE patients
with CVD than SLE patients without CVD (p-value = 0.076). The multivariate regression analysis identified that SDI score
(odds ratio (OR) = 1.74 with 95% confidence interval (CI) 1.12-2.69, p-value = 0.013), and waist circumference more than
90 centimeters in male or more than 80 centimeters in female (OR = 6.9 with 95% CI 1.20-38.46, p-value = 0.031) were
independently associated risk factors for the occurrence of CVD in SLE patients. The presence of antiphospholipid antibodies
also had a trend toward increased risk of CVD in SLE patients (OR = 4.1 with 95% CI 0.96-17.8, p-value = 0.057).
Conclusion : Lupus damage, waist circumference more than 90 centimeters in male or more than 80 centimeters in female
were the independent risk factors for CVD in SLE patients.
Keywords : Cardiovascular disease, Prevalence, Risk factor, Systemic lupus erythematosus
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