Incidence and risk analysis of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus: A nationwide population-based study in Taiwan

S. H. Wang, Y. S. Chang, C. J. Liu, C. C. Lai, T. J. Chen, W. S. Chen

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: The objective of our study was to determine the incidence rates and risk factors of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus (SLE) using a nationwide population-based data set. Methods: We conducted a retrospective cohort study using data from the Taiwan National Health Insurance database. Patients with SLE and age-, sex- and comorbidity-matched control patients without SLE were identified. The primary endpoint was the first occurrence of aortic aneurysm or aortic dissection. The incidence rate ratios (IRRs) were calculated based on a 95% confidence interval (CI). A Cox proportional-hazards model was used to evaluate the risk factors for aortic aneurysm and aortic dissection in the SLE cohort. Results: Among the 15,209 patients with SLE (89.9% women and mean age of 38.3 years), 20 developed aortic aneurysm and 13 developed aortic dissection (overall incidence rate, 4.26 per 10,000 person-years). Compared with the control patients, the overall IRR for developing aortic aneurysm or aortic dissection was 3.34 (95% CI, 1.71-6.91; p<0.001). The IRRs for aortic aneurysm or aortic dissection were 2.98 (95% CI, 1.41-6.70, p=0.018) for women and 5.50 (95% CI, 1.10-53.15, p=0.020) for men. Multivariate Cox regression analysis showed that age, male sex, an SLE diagnosis greater than three years prior and hypertension were associated with aortic aneurysm and aortic dissection. Conclusion: Aortic aneurysm and aortic dissection occur at higher rates in SLE patients than in people without SLE and a longer disease duration is associated with a higher risk of these rare vascular complications. © The Author(s), 2014.

Original languageEnglish
Pages (from-to)665-671
Number of pages7
JournalLupus
Volume23
Issue number7
DOIs
Publication statusPublished - 2014

Fingerprint

Aortic Aneurysm
Taiwan
Systemic Lupus Erythematosus
Dissection
Incidence
Population
Confidence Intervals
National Health Programs
Proportional Hazards Models
Blood Vessels
Comorbidity
Cohort Studies
Retrospective Studies
Regression Analysis
Databases
Hypertension

Keywords

  • Accelerated atherosclerosis
  • Aortic aneurysm
  • Aortic dissection
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

Cite this

Incidence and risk analysis of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus : A nationwide population-based study in Taiwan. / Wang, S. H.; Chang, Y. S.; Liu, C. J.; Lai, C. C.; Chen, T. J.; Chen, W. S.

In: Lupus, Vol. 23, No. 7, 2014, p. 665-671.

Research output: Contribution to journalArticle

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abstract = "Objective: The objective of our study was to determine the incidence rates and risk factors of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus (SLE) using a nationwide population-based data set. Methods: We conducted a retrospective cohort study using data from the Taiwan National Health Insurance database. Patients with SLE and age-, sex- and comorbidity-matched control patients without SLE were identified. The primary endpoint was the first occurrence of aortic aneurysm or aortic dissection. The incidence rate ratios (IRRs) were calculated based on a 95{\%} confidence interval (CI). A Cox proportional-hazards model was used to evaluate the risk factors for aortic aneurysm and aortic dissection in the SLE cohort. Results: Among the 15,209 patients with SLE (89.9{\%} women and mean age of 38.3 years), 20 developed aortic aneurysm and 13 developed aortic dissection (overall incidence rate, 4.26 per 10,000 person-years). Compared with the control patients, the overall IRR for developing aortic aneurysm or aortic dissection was 3.34 (95{\%} CI, 1.71-6.91; p<0.001). The IRRs for aortic aneurysm or aortic dissection were 2.98 (95{\%} CI, 1.41-6.70, p=0.018) for women and 5.50 (95{\%} CI, 1.10-53.15, p=0.020) for men. Multivariate Cox regression analysis showed that age, male sex, an SLE diagnosis greater than three years prior and hypertension were associated with aortic aneurysm and aortic dissection. Conclusion: Aortic aneurysm and aortic dissection occur at higher rates in SLE patients than in people without SLE and a longer disease duration is associated with a higher risk of these rare vascular complications. {\circledC} The Author(s), 2014.",
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T1 - Incidence and risk analysis of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus

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N2 - Objective: The objective of our study was to determine the incidence rates and risk factors of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus (SLE) using a nationwide population-based data set. Methods: We conducted a retrospective cohort study using data from the Taiwan National Health Insurance database. Patients with SLE and age-, sex- and comorbidity-matched control patients without SLE were identified. The primary endpoint was the first occurrence of aortic aneurysm or aortic dissection. The incidence rate ratios (IRRs) were calculated based on a 95% confidence interval (CI). A Cox proportional-hazards model was used to evaluate the risk factors for aortic aneurysm and aortic dissection in the SLE cohort. Results: Among the 15,209 patients with SLE (89.9% women and mean age of 38.3 years), 20 developed aortic aneurysm and 13 developed aortic dissection (overall incidence rate, 4.26 per 10,000 person-years). Compared with the control patients, the overall IRR for developing aortic aneurysm or aortic dissection was 3.34 (95% CI, 1.71-6.91; p<0.001). The IRRs for aortic aneurysm or aortic dissection were 2.98 (95% CI, 1.41-6.70, p=0.018) for women and 5.50 (95% CI, 1.10-53.15, p=0.020) for men. Multivariate Cox regression analysis showed that age, male sex, an SLE diagnosis greater than three years prior and hypertension were associated with aortic aneurysm and aortic dissection. Conclusion: Aortic aneurysm and aortic dissection occur at higher rates in SLE patients than in people without SLE and a longer disease duration is associated with a higher risk of these rare vascular complications. © The Author(s), 2014.

AB - Objective: The objective of our study was to determine the incidence rates and risk factors of aortic aneurysm and aortic dissection among patients with systemic lupus erythematosus (SLE) using a nationwide population-based data set. Methods: We conducted a retrospective cohort study using data from the Taiwan National Health Insurance database. Patients with SLE and age-, sex- and comorbidity-matched control patients without SLE were identified. The primary endpoint was the first occurrence of aortic aneurysm or aortic dissection. The incidence rate ratios (IRRs) were calculated based on a 95% confidence interval (CI). A Cox proportional-hazards model was used to evaluate the risk factors for aortic aneurysm and aortic dissection in the SLE cohort. Results: Among the 15,209 patients with SLE (89.9% women and mean age of 38.3 years), 20 developed aortic aneurysm and 13 developed aortic dissection (overall incidence rate, 4.26 per 10,000 person-years). Compared with the control patients, the overall IRR for developing aortic aneurysm or aortic dissection was 3.34 (95% CI, 1.71-6.91; p<0.001). The IRRs for aortic aneurysm or aortic dissection were 2.98 (95% CI, 1.41-6.70, p=0.018) for women and 5.50 (95% CI, 1.10-53.15, p=0.020) for men. Multivariate Cox regression analysis showed that age, male sex, an SLE diagnosis greater than three years prior and hypertension were associated with aortic aneurysm and aortic dissection. Conclusion: Aortic aneurysm and aortic dissection occur at higher rates in SLE patients than in people without SLE and a longer disease duration is associated with a higher risk of these rare vascular complications. © The Author(s), 2014.

KW - Accelerated atherosclerosis

KW - Aortic aneurysm

KW - Aortic dissection

KW - Systemic lupus erythematosus

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