uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Predictors of the first cardiovascular event in patients with systemic lupus erythematosus: a prospective cohort study
Rheumatology Unit, Department of Medicine Karolinska University Hospital, Solna, Sweden.
Show others and affiliations
2009 (English)In: Arthritis Research & Therapy, ISSN 1478-6362, Vol. 11, no 6, R186- p.Article in journal (Refereed) Published
Abstract [en]


Cardiovascular disease (CVD) is a major cause of premature mortality among Systemic lupus erythematosus (SLE) patients. Many studies have measured and evaluated risk factors for premature subclinical atherosclerosis, but few studies are prospective and few have evaluated risk factors for hard endpoints, i.e. clinically important cardiovascular events (CVE). We investigated the impact of traditional and lupus associated risk factors for the first ever CVE in a longitudinal cohort of SLE patients.


A total of 182 SLE patients (mean age 43.9 years) selected to be free of CVE were included. Cardiovascular and autoimmune biomarkers were measured on samples collected after overnight fasting at baseline. Clinical information was collected at baseline and at follow up. End point was the first ever CVE (ischemic heart, cerebrovascular or peripheral vascular disease or death due to CVD). Impact of baseline characteristics/biomarkers on the risk of having a first CVE was evaluated with Cox regression.


Follow up was 99.5% after a mean time of 8.3 years. Twenty-four patients (13%) had a first CVE. In age-adjusted Cox regression, any positive antiphospholipid antibody (aPL), elevated markers of endothelial activation (von Willebrand factor (vWf), soluble vascular cellular adhesion molecule-1 (sVCAM-1)) and fibrinogen predicted CVEs. Of SLE manifestations, arthritis, pleuritis and previous venous occlusion were positively associated with future CVEs while thrombocytopenia was negatively associated. Among traditional risk factors only age and smoking were significant predictors. In a multivariable Cox regression model age, any positive aPL, vWf and absence of thrombocytopenia were all predictors of the first CVE.


In addition to age, positive aPL, biomarkers indicating increased endothelial cell activity/damage, and absence of thrombocytopenia were independent predictors of CVEs in this prospective study. Our results indicate that activation of the endothelium and the coagulation system are important features in SLE related CVD. Furthermore, we observed that the risk of CVEs seems to differ between subgroups of SLE patients.

Place, publisher, year, edition, pages
2009. Vol. 11, no 6, R186- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-120860DOI: 10.1186/ar2878ISI: 000278282100026PubMedID: 20003285OAI: oai:DiVA.org:uu-120860DiVA: diva2:304042
Available from: 2010-03-16 Created: 2010-03-16 Last updated: 2013-02-08Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Pettersson, SusanneLarsson, Anders
By organisation
Clinical Chemistry
In the same journal
Arthritis Research & Therapy
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 191 hits
ReferencesLink to record
Permanent link

Direct link