Patients with systemic lupus erythematosus face a high risk of cardiovascular disease: A systematic review and Meta-analysis

Objective: Patients with systemic lupus erythematosus (SLE) have increased mortality related to cardiovascular disease (CVD). This systematic review and meta-analysis identified the risk of CVD in SLE patients, CVD risk factors in SLE patients, and the risk of CVD in lupus nephritis (LN) patients. Methods: On-line databases were used to search the eligible studies from January 2013 to August 2020. The relevant characteristics and the data of disease extracted from included publications. Results: A total of 20 studies were included in this meta-analysis. Compared with the general or healthy population, the risk of CVD in SLE patients increased by 2 times (RR = 2.35, 95% CI: 1.95?2.84, P < 0.05). SLE patients had a significantly increased risk of atherosclerosis (RR = 2.31, 95% CI: 1.16?4.60), stroke (RR = 2.30, 95% CI: 1.52?3.50), myocardial infarction (RR = 2.66, 95% CI: 1.97?3.59), peripheral vascular disease (RR = 2.56, 95% CI: 1.07?6.09) and heart failure (RR = 2.89, 95% CI: 1.63?5.13), but no significant increased risk of coronary artery disease (RR = 1.93, 95% CI: 0.67?5.59). SLE patients were more susceptible to lead hypertension than general or healthy population (RR = 2.31, 95% CI: 1.62?3.29). Compared with the SLE patients, the risk of CVD in LN patients was increased by 2 times (RR = 1.75, 95% CI: 1.13?2.70). Conclusion: The results of this meta-analysis suggest that SLE patients have a higher risk of developing CVD compared with the general or healthy population, and the risk of CVD in LN patients is significantly higher than that in SLE patients.

Automated summary

The systematic review and meta-analysis found that patients with systemic lupus erythematosus (SLE) have a higher risk of developing cardiovascular disease (CVD) compared to the general or healthy population, and the risk of CVD in lupus nephritis (LN) patients is significantly higher than in SLE patients.