SLE leads to Increased Risk of Major Adverse Cardiac Events after surgery, finds study

MACE (defined as mortality, ischemic stroke, myocardial infarction, or pulmonary embolism according to International Classification of Diseases [ICD]) within 1 month of surgery was the main outcome. After correcting for RCRI score and race, multivariable conditional logistic regression was performed to assess the chances of the primary outcome across the three cohorts. Multivariable logistic regression models for MACE in SLE patients included the RCRI score, age, race, gender, and SLE disease activity as measured by the Garris index.

A total of 4,750 SLE patients were included, as well as 484,986 non-diabetic controls and 496,381 diabetes controls. After matching, no significant variations in MACE rates were seen between SLE and diabetic individuals. Without correction, SLE patients exhibited a higher incidence of MACE compared to non-diabetic controls; however, after controlling for RCRI scores, the connection became non-significant. Higher RCRI scores, longer age, and non-white race were related with an increased risk of MACE in SLE patients, but not gender, pre-operative cardiac tests, or SLE disease activity.

In conclusion, the findings of this study suggest that SLE, regardless of illness severity, increases the risk of MACE, which is mediated by pre-existing cardiovascular disease.

Reference:

Bruera S, Lei X, Blau B, et al. Increased risk of major adverse cardiac events in patients with systemic lupus erythematosus after non-cardiac surgery. Presented at: ACR Convergence 2021; November 3-10, 2021. Abstract 128.