Cardiovascular events prior to or early after diagnosis of systemic lupus erythematosus in the systemic lupus international collaborating clinics cohort

Research output: Contribution to journalArticle


Objective To describe the frequency of myocardial infarction (MI) prior to the diagnosis of systemic lupus erythematosus (SLE) and within the first 2 years of follow-up. Methods The systemic lupus international collaborating clinics (SLICC) atherosclerosis inception cohort enters patients within 15 months of SLE diagnosis. MIs were reported and attributed on a specialised vascular event form. MIs were confirmed by one or more of the following: abnormal ECG, typical or atypical symptoms with ECG abnormalities and elevated enzymes (≥2 times upper limit of normal), or abnormal stress test, echocardiogram, nuclear scan or angiogram. Descriptive statistics were used. Results 31 of 1848 patients who entered the cohort had an MI. Of those, 23 patients had an MI prior to SLE diagnosis or within the first 2 years of disease. Of the 23 patients studied, 60.9% were female, 78.3% were Caucasian, 8.7% black, 8.7% Hispanic and 4.3% other. The mean age at SLE diagnosis was 52.5±15.0 years. Of the 23 MIs that occurred, 16 MIs occurred at a mean of 6.1±7.0 years prior to diagnosis and 7 occurred within the first 2 years of follow-up. Risk factors associated with early MI in univariate analysis are male sex, Caucasian, older age at diagnosis, hypertension, hypercholesterolaemia, family history of MI and smoking. In multivariate analysis only age (OR=1.06 95% CI 1.03 to 1.09), hypertension (OR=5.01, 95% CI 1.38 to 18.23), hypercholesterolaemia (OR=4.43, 95% CI 1.51 to 12.99) and smoking (OR=7.50, 95% CI 2.38 to 23.57) remained significant risk factors. Conclusions In some patients with lupus, MI may develop even before the diagnosis of SLE or shortly thereafter, suggesting that there may be a link between autoimmune inflammation and atherosclerosis.


  • M. B. Urowitz
  • D. D. Gladman
  • N. M. Anderson
  • J. Su
  • J. Romero-Diaz
  • S. C. Bae
  • P. R. Fortin
  • J. Sanchez-Guerrero
  • A. Clarke
  • S. Bernatsky
  • C. Gordon
  • J. G. Hanly
  • D. J. Wallace
  • D. Isenberg
  • A. Rahman
  • J. Merrill
  • E. Ginzler
  • G. S. Alarcón
  • B. F. Fessler
  • M. Petri
  • I. N. Bruce
  • M. Khamashta
  • C. Aranow
  • M. Dooley
  • S. Manzi
  • R. Ramsey-Goldman
  • G. Sturfelt
  • K. Steinsson
  • A. Zoma
  • G. Ruiz-Irastorza
  • S. Lim
  • K. C. Kalunian
  • M. Inanç
  • R. Van Vollenhoven
  • M. Ramos-Casals
  • D. L. Kamen
  • S. Jacobsen
  • C. Peschken
  • A. Askanase
  • T. Stoll
External organisations
  • University of Toronto
  • Instituto Nacional de Ciencias Médicas y Nutrición
  • Hanyang University
  • Centre hospitalier universitaire de Québec
  • University of Calgary
  • Montreal General Hospital
  • University of Birmingham
  • Dalhousie University
  • Jonsson Comprehensive Cancer Center
  • University College London
  • Oklahoma Medical Research Foundation
  • State University of New York Downstate Medical Center
  • University of Alabama
  • Johns Hopkins University School of Medicine
  • University of Manchester
  • Great Ormond Street Hospital
  • Feinstein Institute for Medical Research
  • University of North Carolina
  • Northwestern University Feinberg School of Medicine
  • National University Hospital of Iceland
  • Hairmyres Hospital
  • University of the Basque Country
  • Emory University
  • Karolinska Institutet
  • Hospital Clínic of Barcelona
  • Medical University of South Carolina
  • Copenhagen University Hospital
  • University of Manitoba
  • Columbia University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Rheumatology and Autoimmunity


  • Cardiovascular Disease, Inflammation, Systemic Lupus Erythematosus
Original languageEnglish
Article numbere000143
JournalLupus Science and Medicine
Issue number1
Publication statusPublished - 2016 Jan 1
Publication categoryResearch