Cardiovascular Damage in Systemic Lupus Erythematosus Develops Early and Persists Throughout Disease: BMJ

Spain: A recent study published in Lupus Science & Medicine concluded that new damage primarily develops within the first year after a systemic lupus erythematosus (SLE) diagnosis, with cardiovascular issues significant throughout the early and late stages of the disease. Early implementation of strategies to prevent cardiovascular damage is crucial following an SLE diagnosis.

Systemic lupus erythematosus is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It affects the skin, joints, kidneys, brain, and other organs. SLE is more common in women than men by nearly 10 to 1. Irene Altabás-González from the rheumatology department, Vigo University Hospital Group, Vigo, Spain, et.al, conducted a study to assess organ damage, especially the cardiovascular system at the different stages of the disease.

For this purpose, the research team conducted a cohort study with 4219 patients enrolled in Spanish Society of Rheumatology Lupus Registry. Using Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) the organ damage was noted. They analyzed 1274 patients over time whose dates of damage events had been recorded.

The findings revealed that:

• In the first year following an SLE diagnosis, 20% of the 1274 patients developed new damage manifestations.

• In the second and third years, new damage was observed in 11% and 9% of patients, respectively. After the fifth year, the annual percentage of patients with new damage declined to 5%.

• During the first year of the disease, most damage occurred in the musculoskeletal, neuropsychiatric, and renal systems. In later stages, the musculoskeletal, ocular, and cardiovascular systems were predominantly affected.

• When including ‘cerebrovascular accident’ and ‘claudication for 6 months’ as cardiovascular items, the cardiovascular system emerged as the second most affected system in the early stages of SLE, with 19% of patients who presented with damage being affected in the first year after diagnosis.

• In the later stages, 20-25% of patients presenting with new damage were affected in this modified cardiovascular domain of the SDI.

“The researchers concluded that cardiovascular damage occurs during the first year after the diagnosis of SLE. Strategies need to be adopted to prevent organ damage and cardiovascular diseases at early and late stages,”, researchers concluded.

Reference

Altabás-González, I., Rua-Figueroa, I., Mouriño, C., Roberts, K., Jimenez, N., Martinez-Barrio, J., Galindo, M., Calvo Alén, J., Pérez, V. D. C., Uriarte Itzazelaia, E., Tomero, E., Freire-González, M., Martínez Taboada, V., Salgado, E., Vela, P., Fernandez-Nebro, A., Olivé, A., Narváez, J., Menor-Almagro, R., Soler, G. S., … Pego-Reigosa, J. M. (2024). Damage in a large systemic lupus erythematosus cohort from the Spanish Society of Rheumatology Lupus Registry (RELESSER) with emphasis on the cardiovascular system: a longitudinal analysis. Lupus science & medicine, 11(2), e001064. https://doi.org/10.1136/lupus-2023-001064