TY - JOUR
T1 - Major adverse cardiovascular events and mortality in systemic lupus erythematosus patients after successful delivery
T2 - A population-based study
AU - Wu, Lung Sheng
AU - Tang, Chao Hsiun
AU - Lin, Yu Sheng
AU - Lin, Chia Pin
AU - Hung, Sheng Tzu
AU - Hwa, Hsiao Lin
AU - Luo, Shue Fen
AU - Chu, Pao Hsien
N1 - Funding Information:
This study was supported by Chang Gung Memorial Hospital grant CMRP500011 (to Y-SL); the NHRI, Taiwan, grants NHRI-EX91-9108SC, NHRI-EX92-9108SC, NHRI-EX-93-9108SC, NHRI-EX94-9108SC and NHRI-EX95-9108SC (to P-HC); Chang Gung Memorial Hospital grant CMRPG32057 (to P-HC); the National Sciences Council, Taiwan, grant NSC 94-2089-B-188-888 (to P-HC).
PY - 2014/1
Y1 - 2014/1
N2 - BACKGROUND:: Limited data exist regarding the incidence rate and hazard ratios (HRs) of major adverse cardiovascular events and mortality in the successful-delivery women with or without systemic lupus erythematosus. METHODS:: A retrospective, population-based cohort study was performed on 1,132,089 parturients from 1999 to 2003. The Kaplan-Meier method and the log-rank test were used to examine the effect of systemic lupus erythematosus on the incidence of major adverse cardiovascular events and mortality. Cox-proportional hazard regression modeling was used to determine the adjusted HRs of systemic lupus erythematosus on the risk of major adverse cardiovascular events and mortality among successful-delivery women. RESULTS:: Systemic lupus erythematosus group has the highest risk for major adverse cardiovascular events and mortality. The incidence rate of major adverse cardiovascular events and all-causes mortality among lupus women was 194.67 and 438.82 per 100,000 patients per year, respectively. Lupus women had higher incidence rates of major adverse cardiovascular events, including myocardial infarction, (HR, 54.43; confidence interval [CI], 16.04-184.78; P < 0.0001), heart failure (HR, 11.10; CI, 2.71-45.52; P < 0.0001), percutaneous coronary intervention (HR, 228.32; CI, 43.34-1203.00; P < 0.0001), stroke (HR, 8.02; CI, 3.79-16.99; P < 0.0001) and maternal death (HR, 11.68; CI, 7.97-17.10; P < 0.0001). CONCLUSIONS:: Although major adverse cardiovascular events and mortality are rare events in women of reproductive age, the incidence rates have increased approximately 10-fold among lupus women with successful delivery. Clinicians should note the possibility of persisting major adverse cardiovascular events and death in young women with lupus and successful delivery.
AB - BACKGROUND:: Limited data exist regarding the incidence rate and hazard ratios (HRs) of major adverse cardiovascular events and mortality in the successful-delivery women with or without systemic lupus erythematosus. METHODS:: A retrospective, population-based cohort study was performed on 1,132,089 parturients from 1999 to 2003. The Kaplan-Meier method and the log-rank test were used to examine the effect of systemic lupus erythematosus on the incidence of major adverse cardiovascular events and mortality. Cox-proportional hazard regression modeling was used to determine the adjusted HRs of systemic lupus erythematosus on the risk of major adverse cardiovascular events and mortality among successful-delivery women. RESULTS:: Systemic lupus erythematosus group has the highest risk for major adverse cardiovascular events and mortality. The incidence rate of major adverse cardiovascular events and all-causes mortality among lupus women was 194.67 and 438.82 per 100,000 patients per year, respectively. Lupus women had higher incidence rates of major adverse cardiovascular events, including myocardial infarction, (HR, 54.43; confidence interval [CI], 16.04-184.78; P < 0.0001), heart failure (HR, 11.10; CI, 2.71-45.52; P < 0.0001), percutaneous coronary intervention (HR, 228.32; CI, 43.34-1203.00; P < 0.0001), stroke (HR, 8.02; CI, 3.79-16.99; P < 0.0001) and maternal death (HR, 11.68; CI, 7.97-17.10; P < 0.0001). CONCLUSIONS:: Although major adverse cardiovascular events and mortality are rare events in women of reproductive age, the incidence rates have increased approximately 10-fold among lupus women with successful delivery. Clinicians should note the possibility of persisting major adverse cardiovascular events and death in young women with lupus and successful delivery.
KW - Major adverse cardiovascular events
KW - Mortality
KW - Systemic lupus erythematosus
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U2 - 10.1097/MAJ.0b013e318278707f
DO - 10.1097/MAJ.0b013e318278707f
M3 - Article
C2 - 23255242
AN - SCOPUS:84891834547
SN - 0002-9629
VL - 347
SP - 42
EP - 49
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 1
ER -