Systemic Lupus Erythematosus; Stroke and Myocardial Infarction Risk: a Systematic Review and Meta-analysis

Overview

Journal RMD Open

Publisher BMJ Publishing Group

Specialty Rheumatology

Date 2020 Sep 9

PMID 32900883

Citations 27

Authors

Jinoos Yazdany

Nick Pooley

Julia Langham

Lindsay Nicholson

Sue Langham

Nina Embleton

Xia Wang

Barnabas Desta

Volkan Barut

Edward Hammond

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the risk of stroke and myocardial infarction (MI) in adult patients with systemic lupus erythematosus (SLE) through a systematic review and meta-analysis.

Methods: We searched MEDLINE and EMBASE from inception to May 2020 to identify observational studies (cohort and cross-sectional) that evaluated risk of stroke and MI in adult patients with SLE compared with the general population or healthy controls. Studies were included if they reported effect-size estimates that could be used for calculating pooled-effect estimates. Random-effects models were used to calculate pooled risk ratios (RRs) and 95% CIs for stroke and MI. Heterogeneity quantified by the I test and sensitivity analyses assessed bias.

Results: In total, 26 studies were included in this meta-analysis: 14, 5 and 7 studies on stroke, MI and both stroke and MI, respectively. The pooled RR for ischaemic stroke was 2.18 (95% CI 1.78 to 2.67; I 75%), intracerebral haemorrhage 1.84 (95% CI 1.16 to 2.90; I 67%), subarachnoid haemorrhage 1.95 (95% CI 0.69 to 5.52; I 94%), composite stroke 2.13 (95% CI 1.73 to 2.61; I 88%) and MI 2.99 (95% CI 2.34 to 3.82; I 85%). There was no evidence for publication bias, and sensitivity analyses confirmed the robustness of the results.

Conclusions: Overall, patients with SLE were identified to have a twofold to threefold higher risk of stroke and MI. Future research on the interaction between known SLE-specific modifiable risk factors and risk of stroke and MI to support development of prevention and treatment strategies are needed.

Prospero Registration Number: CRD42018098690.

Citing Articles

Cardiovascular disease risk in Korean patients with systemic lupus erythematosus compared to diabetes mellitus and the general population.

Han J, Cho S, Jeon Y, Kang G, Jung S, Jang E Sci Rep. 2025; 15(1):3208.

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Prevalence of cardiovascular events in a population-based registry of patients with systemic lupus erythematosus.

Joyce D, Berger J, Guttmann A, Hasan G, Buyon J, Belmont H Arthritis Res Ther. 2024; 26(1):160.

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The Aconitate Decarboxylase 1/Itaconate Pathway Modulates Immune Dysregulation and Associates with Cardiovascular Disease Markers and Disease Activity in Systemic Lupus Erythematosus.

Patino-Martinez E, Nakabo S, Jiang K, Carmona-Rivera C, Tsai W, Claybaugh D J Immunol. 2024; 213(4):419-434.

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Unveiling shared biomarkers and therapeutic targets between systemic lupus erythematosus and heart failure through bioinformatics analysis.

Zhou T, Pan J, Yan C, Yuan J, Song H, Han Y Front Med (Lausanne). 2024; 11:1402010.

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Interferon Upregulation Associates with Insulin Resistance in Humans.

Adeva-Andany M, Carneiro-Freire N, Castro-Quintela E, Ameneiros-Rodriguez E, Adeva-Contreras L, Fernandez-Fernandez C Curr Diabetes Rev. 2024; 21(3):86-105.

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