Major adverse cardiovascular events and mortality in systemic lupus erythematosus patients after successful delivery

A population-based study

Lung Sheng Wu, Chao Hsiun Tang, Yu Sheng Lin, Chia Pin Lin, Sheng Tzu Hung, Hsiao Lin Hwa, Shue Fen Luo, Pao Hsien Chu

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

BACKGROUND:: Limited data exist regarding the incidence rate and hazard ratios (HRs) of major adverse cardiovascular events and mortality in the successful-delivery women with or without systemic lupus erythematosus. METHODS:: A retrospective, population-based cohort study was performed on 1,132,089 parturients from 1999 to 2003. The Kaplan-Meier method and the log-rank test were used to examine the effect of systemic lupus erythematosus on the incidence of major adverse cardiovascular events and mortality. Cox-proportional hazard regression modeling was used to determine the adjusted HRs of systemic lupus erythematosus on the risk of major adverse cardiovascular events and mortality among successful-delivery women. RESULTS:: Systemic lupus erythematosus group has the highest risk for major adverse cardiovascular events and mortality. The incidence rate of major adverse cardiovascular events and all-causes mortality among lupus women was 194.67 and 438.82 per 100,000 patients per year, respectively. Lupus women had higher incidence rates of major adverse cardiovascular events, including myocardial infarction, (HR, 54.43; confidence interval [CI], 16.04-184.78; P <0.0001), heart failure (HR, 11.10; CI, 2.71-45.52; P <0.0001), percutaneous coronary intervention (HR, 228.32; CI, 43.34-1203.00; P <0.0001), stroke (HR, 8.02; CI, 3.79-16.99; P <0.0001) and maternal death (HR, 11.68; CI, 7.97-17.10; P <0.0001). CONCLUSIONS:: Although major adverse cardiovascular events and mortality are rare events in women of reproductive age, the incidence rates have increased approximately 10-fold among lupus women with successful delivery. Clinicians should note the possibility of persisting major adverse cardiovascular events and death in young women with lupus and successful delivery.

Original languageEnglish
Pages (from-to)42-49
Number of pages8
JournalAmerican Journal of the Medical Sciences
Volume347
Issue number1
DOIs
Publication statusPublished - Jan 2014

Fingerprint

Systemic Lupus Erythematosus
Mortality
Confidence Intervals
Population
Incidence
Maternal Death
Percutaneous Coronary Intervention
Cohort Studies
Heart Failure
Stroke
Myocardial Infarction
Parturition

Keywords

  • Major adverse cardiovascular events
  • Mortality
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Major adverse cardiovascular events and mortality in systemic lupus erythematosus patients after successful delivery : A population-based study. / Wu, Lung Sheng; Tang, Chao Hsiun; Lin, Yu Sheng; Lin, Chia Pin; Hung, Sheng Tzu; Hwa, Hsiao Lin; Luo, Shue Fen; Chu, Pao Hsien.

In: American Journal of the Medical Sciences, Vol. 347, No. 1, 01.2014, p. 42-49.

Research output: Contribution to journalArticle

Wu, Lung Sheng ; Tang, Chao Hsiun ; Lin, Yu Sheng ; Lin, Chia Pin ; Hung, Sheng Tzu ; Hwa, Hsiao Lin ; Luo, Shue Fen ; Chu, Pao Hsien. / Major adverse cardiovascular events and mortality in systemic lupus erythematosus patients after successful delivery : A population-based study. In: American Journal of the Medical Sciences. 2014 ; Vol. 347, No. 1. pp. 42-49.
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T2 - A population-based study

AU - Wu, Lung Sheng

AU - Tang, Chao Hsiun

AU - Lin, Yu Sheng

AU - Lin, Chia Pin

AU - Hung, Sheng Tzu

AU - Hwa, Hsiao Lin

AU - Luo, Shue Fen

AU - Chu, Pao Hsien

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N2 - BACKGROUND:: Limited data exist regarding the incidence rate and hazard ratios (HRs) of major adverse cardiovascular events and mortality in the successful-delivery women with or without systemic lupus erythematosus. METHODS:: A retrospective, population-based cohort study was performed on 1,132,089 parturients from 1999 to 2003. The Kaplan-Meier method and the log-rank test were used to examine the effect of systemic lupus erythematosus on the incidence of major adverse cardiovascular events and mortality. Cox-proportional hazard regression modeling was used to determine the adjusted HRs of systemic lupus erythematosus on the risk of major adverse cardiovascular events and mortality among successful-delivery women. RESULTS:: Systemic lupus erythematosus group has the highest risk for major adverse cardiovascular events and mortality. The incidence rate of major adverse cardiovascular events and all-causes mortality among lupus women was 194.67 and 438.82 per 100,000 patients per year, respectively. Lupus women had higher incidence rates of major adverse cardiovascular events, including myocardial infarction, (HR, 54.43; confidence interval [CI], 16.04-184.78; P <0.0001), heart failure (HR, 11.10; CI, 2.71-45.52; P <0.0001), percutaneous coronary intervention (HR, 228.32; CI, 43.34-1203.00; P <0.0001), stroke (HR, 8.02; CI, 3.79-16.99; P <0.0001) and maternal death (HR, 11.68; CI, 7.97-17.10; P <0.0001). CONCLUSIONS:: Although major adverse cardiovascular events and mortality are rare events in women of reproductive age, the incidence rates have increased approximately 10-fold among lupus women with successful delivery. Clinicians should note the possibility of persisting major adverse cardiovascular events and death in young women with lupus and successful delivery.

AB - BACKGROUND:: Limited data exist regarding the incidence rate and hazard ratios (HRs) of major adverse cardiovascular events and mortality in the successful-delivery women with or without systemic lupus erythematosus. METHODS:: A retrospective, population-based cohort study was performed on 1,132,089 parturients from 1999 to 2003. The Kaplan-Meier method and the log-rank test were used to examine the effect of systemic lupus erythematosus on the incidence of major adverse cardiovascular events and mortality. Cox-proportional hazard regression modeling was used to determine the adjusted HRs of systemic lupus erythematosus on the risk of major adverse cardiovascular events and mortality among successful-delivery women. RESULTS:: Systemic lupus erythematosus group has the highest risk for major adverse cardiovascular events and mortality. The incidence rate of major adverse cardiovascular events and all-causes mortality among lupus women was 194.67 and 438.82 per 100,000 patients per year, respectively. Lupus women had higher incidence rates of major adverse cardiovascular events, including myocardial infarction, (HR, 54.43; confidence interval [CI], 16.04-184.78; P <0.0001), heart failure (HR, 11.10; CI, 2.71-45.52; P <0.0001), percutaneous coronary intervention (HR, 228.32; CI, 43.34-1203.00; P <0.0001), stroke (HR, 8.02; CI, 3.79-16.99; P <0.0001) and maternal death (HR, 11.68; CI, 7.97-17.10; P <0.0001). CONCLUSIONS:: Although major adverse cardiovascular events and mortality are rare events in women of reproductive age, the incidence rates have increased approximately 10-fold among lupus women with successful delivery. Clinicians should note the possibility of persisting major adverse cardiovascular events and death in young women with lupus and successful delivery.

KW - Major adverse cardiovascular events

KW - Mortality

KW - Systemic lupus erythematosus

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