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Cardiovascular disease a hazard despite improved prognosis in patients with systemic lupus erythematosus: results from a Swedish population based study 1964-95.
J Rheumatol 2004; 31(4):713-9JR

Abstract

OBJECTIVE

Although short term prognosis has improved in patients with systemic lupus erythematosus (SLE) during the early disease course, less is known about the longterm prognosis.

METHODS

A cohort of 4737 patients with a diagnostic code of SLE was identified 1964-94 in the Swedish Hospital Discharge Register and followed by linkage to the Cause of Death Register until the end of 1995. Mortality was separately analyzed in 3 different calendar periods (1964-75, 1975-84, 1985-95). The relative risk of death was estimated as standardized mortality ratio (SMR) using the Swedish population as a reference.

RESULTS

In total 2314 patients were deceased. Mortality was 3-fold increased (SMR = 3.63, 95% CI 3.49, 3.78) and cardiovascular disease (CVD) was the major cause of death. Patients aged 20-39 years at the first discharge had a 16-fold increased risk of death from coronary heart disease (SMR = 15.99, 95% CI 10.4, 23.6). All-cause mortality had decreased since 1975 and the reason for this decrease was entirely due to a decrease in causes attributed to SLE, but not CVD. Patients aged 20-39 years at the first discharge had a pronounced decrease in mortality, with SMR 33.59 (95% CI 24.3, 45.3) before 1975 compared with SMR 14.23 (95% CI 8.70, 22.0) after 1984.

CONCLUSION

Cardiovascular disease was the major cause of death in patients with SLE and young patients had a pronounced increased risk of death. Even if all-cause mortality had declined during the last 2 decades due to causes attributed to SLE, the risk of cardiovascular death remained unchanged.

Authors+Show Affiliations

Rheumatology Unit, Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden. lena.bjornadal@medks.ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15088296

Citation

Björnådal, Lena, et al. "Cardiovascular Disease a Hazard Despite Improved Prognosis in Patients With Systemic Lupus Erythematosus: Results From a Swedish Population Based Study 1964-95." The Journal of Rheumatology, vol. 31, no. 4, 2004, pp. 713-9.
Björnådal L, Yin L, Granath F, et al. Cardiovascular disease a hazard despite improved prognosis in patients with systemic lupus erythematosus: results from a Swedish population based study 1964-95. J Rheumatol. 2004;31(4):713-9.
Björnådal, L., Yin, L., Granath, F., Klareskog, L., & Ekbom, A. (2004). Cardiovascular disease a hazard despite improved prognosis in patients with systemic lupus erythematosus: results from a Swedish population based study 1964-95. The Journal of Rheumatology, 31(4), pp. 713-9.
Björnådal L, et al. Cardiovascular Disease a Hazard Despite Improved Prognosis in Patients With Systemic Lupus Erythematosus: Results From a Swedish Population Based Study 1964-95. J Rheumatol. 2004;31(4):713-9. PubMed PMID: 15088296.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular disease a hazard despite improved prognosis in patients with systemic lupus erythematosus: results from a Swedish population based study 1964-95. AU - Björnådal,Lena, AU - Yin,Li, AU - Granath,Fredrik, AU - Klareskog,Lars, AU - Ekbom,Anders, PY - 2004/4/17/pubmed PY - 2004/6/4/medline PY - 2004/4/17/entrez SP - 713 EP - 9 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 31 IS - 4 N2 - OBJECTIVE: Although short term prognosis has improved in patients with systemic lupus erythematosus (SLE) during the early disease course, less is known about the longterm prognosis. METHODS: A cohort of 4737 patients with a diagnostic code of SLE was identified 1964-94 in the Swedish Hospital Discharge Register and followed by linkage to the Cause of Death Register until the end of 1995. Mortality was separately analyzed in 3 different calendar periods (1964-75, 1975-84, 1985-95). The relative risk of death was estimated as standardized mortality ratio (SMR) using the Swedish population as a reference. RESULTS: In total 2314 patients were deceased. Mortality was 3-fold increased (SMR = 3.63, 95% CI 3.49, 3.78) and cardiovascular disease (CVD) was the major cause of death. Patients aged 20-39 years at the first discharge had a 16-fold increased risk of death from coronary heart disease (SMR = 15.99, 95% CI 10.4, 23.6). All-cause mortality had decreased since 1975 and the reason for this decrease was entirely due to a decrease in causes attributed to SLE, but not CVD. Patients aged 20-39 years at the first discharge had a pronounced decrease in mortality, with SMR 33.59 (95% CI 24.3, 45.3) before 1975 compared with SMR 14.23 (95% CI 8.70, 22.0) after 1984. CONCLUSION: Cardiovascular disease was the major cause of death in patients with SLE and young patients had a pronounced increased risk of death. Even if all-cause mortality had declined during the last 2 decades due to causes attributed to SLE, the risk of cardiovascular death remained unchanged. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/15088296/Cardiovascular_disease_a_hazard_despite_improved_prognosis_in_patients_with_systemic_lupus_erythematosus:_results_from_a_Swedish_population_based_study_1964_95_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=15088296 DB - PRIME DP - Unbound Medicine ER -