SAT0201 CARDIOVASCULAR EVENTS IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE): THE ROLE OF TRADITIONAL CARDIOVASCULAR RISK AND SLE-RELATED FACTORS
Authors: Anna Maria Paglionico, Valentina Varriano, Luca Petricca, Clara DI Mario, Maria Rita Gigante, Giacomo Tanti, Barbara Tolusso, Gianfranco Ferraccioli, Elisa Gremese
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Patients with SLE may have an increased risk of cardiovascular (CV) events due to the contribution of disease-related factors. Objectives: to determine the prognostic role of traditional CV risk factors and SLE-related factors in the assessment of the risk of CV events development in a cohort of patients affected by SLE. <h3>Methods:</h3> Two hundred and sixty two consecutive SLE patients (age 42.9 ± 14.5 years, 89% female, disease duration 11.5 ± 8.2 years) have been evaluated, 240 (92%) with articular, 226 (86%) with cutaneous, 167 (64%) with hematological, 61 (23%) with serositis involvement respectively and 86 (33%) with lupus nephritis (LN) and 105 (40%) with neuropsychiatric SLE (NPSLE). The follow-up data were collected and information on traditional CV risk factors (age, sex, diabetes, smoking, arterial hypertension, dyslipidemia), disease-specific parameters (SLEDAI-2K, chronic steroid therapy, current antimalarial and other immunosuppressive therapy) and autoantibody profile (ANA, anti-SSa/Ro, anti-SSb/La, IgA and IgM Rheumatoid factor (RF), complement reduction, anticardiolipin (ACLA), antibeta2glicoprotein 1 (antiβ2GP1), lupus anticoagulant (LAC)) were analyzed for each patient. As CV manifestations, acute cardiac and cerebrovascular ischemic events and chronic ischemic heart disease were considered. <h3>Results:</h3> Twenty-seven SLE patients (10.3%) experienced CV events during the follow-up period with a significantly higher rate of male sex (24% in males vs 8.6% in females, p=0.01) among the considered demographical parameters. Among those patients, 10 (37%) presented cerebrovascular accidents, 6 (22%) acute cardiac ischemic events, 7 (26%) chronic ischemic heart disease and 4 (15%) both cardiac and cerebrovascular events during the follow up period. In particular, SLE patients who experienced CV events during the follow up were older at disease onset than patients who did not experience CV events during the follow-up (42.2 ± 19.4 vs 29.8 ± 13.1 years, p&lt;0.001). Considering the traditional CV-related risk factors, among the SLE cohort, patients who experienced CV events during the follow-up were more likely having concomitant dyslipidemia (p=0.03), diabetes mellitus (p=0.01) and arterial hypertension (p&lt;0.001) compared to SLE patients who did not experience CV events. Considering the disease-related parameters, no significant association between CV events development and ANA, anti-SSa/Ro, anti-SSB/La positivity and complement reduction was found (p&gt;0.05) despite SLE patients who experienced CV events during the follow-up were more likely with concomitant neurological involvement (p=0.002) and ongoing chronic corticosteroid therapy (p=0.03) compared to SLE patients who did not experience CV events. Finally, considering the antiphospholipid antibodies (aPL) profile, SLE patients who experienced CV events during the follow-up were more likely positive for antiβ2GP1 (p &lt;0.0001), ACLA (p&lt;0.0001) and LAC (p &lt;0.0001) compared to SLE patients who did not experience CV events. In addition, multivariate analysis revealed that, aPL positivity arose as an independent risk factor associated with CV events development in SLE patients contingently to the number of aPL positivities (single aPL positivity, OR 4.52 (0.97-21.18); double aPL positivity, OR 23.95 (4.39-130.76); triple APL positivity, OR 34.01 (7.64-151.40)). <h3>Conclusion:</h3> in SLE patients, aPL positivity significantly increases the risk of CV events development regardless to the traditional CV risk factors contingently to the number of aPL positivities. <h3>Reference</h3> [1] Boulos D, Koelmeyer RL, Morand EF and Hoi AY, Lupus Science &amp; Medicine, 2017 <h3>Disclosure of Interests:</h3> Anna Maria Paglionico: None declared, Valentina Varriano: None declared, Luca Petricca: None declared, Clara Di Mario: None declared, Maria Rita Gigante: None declared, Giacomo Tanti: None declared, Barbara Tolusso: None declared, Gianfranco Ferraccioli Speakers bureau: BMS, Roche, Elisa Gremese Consultant for: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Sanofi, UCB, Roche, and Pfizer, Speakers bureau: BMS, Speakers bureau: Roche, Speakers bureau: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Sanofi, UCB, Roche, and Pfizer