Lupus & antiphospholipid syndrome
Cardiovascular events and risk in patients with systemic lupus erythematosus: Systematic literature review and meta-analysis
Authors' conclusion
This meta-analysis found an increased risk of stroke, MI, CVD, and hypertension in patients with SLE compared with the general population, despite substantial heterogeneity across the included studies.
Study context
- Population
- Adult patients with systemic lupus erythematosus (SLE); observational studies published January 2010 to September 2020 (PubMed and Embase)46 studies
- Comparison
- Adults with SLE vs adults without SLE
- Outcome
- RR, AR and IR of CVD events (stroke, MI, CVD [composite or undefined])
Methodological detailsrandom-effects model, Heterogeneity (I2) high in most analyses; sensitivity analyses confirmed robustness of pooled estimates
- Random-effects model
- Heterogeneity (I2) high in most analyses; sensitivity analyses confirmed robustness of pooled estimates
Pooled result
As reported in the abstract
RR of CVD events, SLE vs non-SLE
SLE vs Non-SLE controlsEstimate (95% CI)
12 studies
RR (stroke) 2.51(2.03–3.10)
11 studies
RR (MI) 2.92(2.45–3.48)
8 studies
RR (CVD) 2.24(1.94–2.59)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| CV risk factors: hypertension, diabetes, MetS (RR vs non-SLE controls)Hypertension; 7 studies · random-effects model | 2.70 (1.48–4.92) | |
| 0.20.5125Relative risk (log scale) |
- CV risk factors: hypertension, diabetes, MetS (RR vs non-SLE controls) — RR of diabetes vs adults without SLE, elevated but not significant
- 1.24 (3 studies; 95% CI 0.78-1.96)
- CV risk factors: hypertension, diabetes, MetS (RR vs non-SLE controls) — RR of MetS vs adults without SLE, elevated but not significant
- 1.49 (7 studies; 95% CI 0.95-2.33)
- Absolute risk (AR) (incidence proportion) of cardiovascular disease (CVD) events in SLE
- 0.03 · pooled AR · 95% CI 0.02–0.05
- Incidence rate (IR) of CVD events in SLE, per 1000 person-years
- 4.72 · pooled IR · 95% CI 3.35–6.32 · per 1000 person-years
RR of stroke and MI by age (subgroup)
- RRs of stroke and MI generally higher in younger vs older patients with SLE
Original publication
Cardiovascular events and risk in patients with systemic lupus erythematosus: Systematic literature review and meta-analysis. Lupus. Published 22 December 2022. doi:10.
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