Back to Search
Start Over
Assessment of coronary risk based on cumulative exposure to lipids in systemic lupus erythematosus.
- Source :
-
The Journal of rheumatology [J Rheumatol] 2013 Dec; Vol. 40 (12), pp. 2006-14. Date of Electronic Publication: 2013 Oct 15. - Publication Year :
- 2013
-
Abstract
- Objective: To quantify the independent role of each of low-density lipoprotein cholesterol (LDL-C), total cholesterol:high-density lipoprotein cholesterol ratio (TC:HDL-C), triglyceride (TG) level, and HDL-C as a marker of coronary risk in systemic lupus erythematosus (SLE).<br />Methods: Patients with lipid measurements taken before a coronary event (or last clinic visit) were included. Mean and time-adjusted mean (TAM) levels were calculated for each lipid variable in each patient. Time-dependent proportional hazards regression models were used to quantify the risk of coronary event [myocardial infarction (MI) or angina], after adjustment for age.<br />Results: Among 384 patients, over a mean (SD) followup of 3.81 (2.58) years, there were 21 "first" coronary events (6 MI, 15 angina). Mean and TAM LDL-C (HR 1.83, 95% CI 1.19-2.81, p = 0.006), TC:HDL ratio (HR 1.43, 95% CI 1.02-2.00, p = 0.04), and TG (HR 2.11, 95% CI 1.32-3.39, p = 0.0019) were predictive of coronary event at subsequent visits. In contingency table analysis, TAM LDL-C cutpoint of 2.0 mmol/l had a sensitivity and negative predictive value for coronary event of 85.7% (95% CI 63.7-97.0) and 93.9% (95% CI 83.1-98.7), respectively. However, at this cutpoint the specificity was only 12.7% (95% CI 9.4-16.5).<br />Conclusion: This study links LDL-C, TC:HDL-C ratio, and TG to coronary risk in patients with SLE and quantifies the magnitude of this risk. SLE-specific risk assessment levels for lipids may be selected to optimize positive or negative predictive values.
- Subjects :
- Adult
Angina Pectoris epidemiology
Angina Pectoris metabolism
Cholesterol, HDL blood
Cholesterol, LDL blood
Death, Sudden, Cardiac epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction epidemiology
Myocardial Infarction metabolism
Proportional Hazards Models
Risk Assessment methods
Risk Factors
Sensitivity and Specificity
Triglycerides blood
Coronary Artery Disease epidemiology
Coronary Artery Disease metabolism
Lipids blood
Lupus Erythematosus, Systemic epidemiology
Lupus Erythematosus, Systemic metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 0315-162X
- Volume :
- 40
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The Journal of rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 24128779
- Full Text :
- https://doi.org/10.3899/jrheum.121273