Systemic lupus erythematosus is a risk factor for cardiovascular disease: a nationwide, population-based study in Korea

Objective: To investigate the incidence and clinical significance of cardiovascular disease in systemic lupus erythematosus patients. Methods: We included systemic lupus erythematosus patients (n = 18,575) without previous cardiovascular disease and age- and sex-matched individuals without systemic lupus erythematosus (controls; n = 92,875) from the Korean National Health Insurance Service database (2008–2014). Both cohorts were followed up for incident cardiovascular disease and death until 2015. Results: During follow up, myocardial infarction occurred in 203 systemic lupus erythematosus patients and 325 controls (incidence rate: 1.76 and 0.56 per 1000 person-years, respectively), stroke occurred in 289 patients and 403 controls (incidence rate: 2.51 and 0.70 per 1000 person-years, respectively), heart failure occurred in 358 patients and 354 controls (incidence rate 3.11 and 0.61 per 1000 person-years, respectively), and death occurred in 744 patients and 948 controls (incidence rate 6.54 and 1.64 per 1000 person-years, respectively). Patients with systemic lupus erythematosus had higher risks for myocardial infarction (hazard ratio: 2.74, 95% confidence interval: 2.28–3.37), stroke (hazard ratio: 3.31, 95% confidence interval: 2.84–3.86), heart failure (hazard ratio: 4.60, 95% confidence interval: 3.96–5.35), and cardiac death (hazard ratio: 3.98, 95% confidence interval: 3.61–4.39). Conclusions: Here, systemic lupus erythematosus was an independent risk factor for cardiovascular disease, thus cardiac assessment and management are critical in systemic lupus erythematosus patients.