Adults With SLE Are At Higher Risk for Stroke, Myocardial Infarction

Adults with systemic lupus erythematosus (SLE) have a 2-fold increased risk of stroke and a 3-fold increased risk of myocardial infarction (MI) compared with the general population or healthy controls, according to a new systematic review and meta-analysis.

“Our findings are consistent with a published meta-analysis for stroke in patients with SLE that included studies up to June 2015,” the researchers wrote. “However, the higher number of studies included in our meta-analysis meant increased precision, evidenced by smaller confidence intervals.”

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The meta-analysis synthesized evidence from 26 real-world observational studies evaluating the risk of major cardiovascular events among people with SLE compared with other adults. Of the studies, 14 focused on stroke, 5 on MI, and 7 on both outcomes.

Compared with the general population or healthy controls, adults with SLE had the following pooled risk ratios: 1.84 for intracerebral hemorrhage, 1.95 for subarachnoid hemorrhage, 2.13 for composite stroke, 2.18 for ischemic stroke, and 2.99 for MI.

The researchers found no evidence for publication bias and added that the robustness of the findings was confirmed in sensitivity analyses.

“Known MI and stroke risk factors and SLE-related factors are likely to be associated with the observed elevated risk,” the researchers wrote. “Understanding the various mechanisms underlying increased cardiovascular disease risk in patients with SLE, including how antiphospholipid antibodies or antiphospholipid syndrome may modify this risk, will support prevention and treatment strategies and advance informed patient and physician decisions.”

—Jolynn Tumolo

Reference:

Yazdany J, Pooley N, Langham J, et al. Systemic lupus erythematosus; stroke and myocardial infarction risk: a systematic review and meta-analysis. RMD Open. 2020;6:e001247. doi:10.1136/rmdopen-2020-001247