The Manhattan Lupus Surveillance Program (MLSP), a population-based retrospective registry of patients with systemic lupus erythematosus (SLE), was used to investigate the prevalence of cardiovascular disease events (CVE) and compare rates among sex, age and race/ethnicity to population-based controls. Patients with prevalent SLE in 2007 aged ≥ 20 years in the MLSP were included. CVE required documentation of a myocardial infarction or cerebrovascular accident. We calculated crude risk ratios and adjusted risk ratios (ARR) controlling for sex, age group, race and ethnicity, and years since diagnosis. Data from the 2009–2010 National Health and Nutrition Examination Survey (NHANES) and the 2013–2014 NYC Health and Nutrition Examination Survey (NYC HANES) were used to calculate expected CVE prevalence by multiplying NHANES and NYC HANES estimates by strata-specific counts of patients with SLE. Crude prevalence ratios (PRs) using national and NYC estimates and age standardized prevalence ratios (ASPRs) using national estimates were calculated. CVE occurred in 13.9% of 1,285 MLSP patients with SLE, and risk was increased among men (ARR:1.7, 95%CI:1.2–2.5) and older adults (age > 60 ARR:2.5, 95%CI:1.7–3.8). Compared with non-Hispanic Asian patients, CVE risk was elevated among Hispanic/Latino (ARR:3.1, 95%CI:1.4-7.0) and non-Hispanic Black (ARR:3.5, 95%CI1.6-7.9) patients as well as those identified as non-Hispanic and in another or multiple racial groups (ARR:4.2, 95%CI:1.1–15.8). Overall, CVE prevalence was higher among patients with SLE than nationally (ASPR:3.1, 95%CI:3.0-3.1) but did not differ by sex. Compared with national race and ethnicity-stratified estimates, CVE among patients with SLE was highest among Hispanics/Latinos (ASPR:4.3, 95%CI:4.2–4.4). CVE was also elevated among SLE registry patients compared with all NYC residents. Comparisons with age-stratified national estimates revealed PRs of 6.4 (95%CI:6.2–6.5) among patients aged 20–49 years and 2.2 (95%CI:2.1–2.2) among those ≥ 50 years. Male (11.3, 95%CI:10.5–12.1), Hispanic/Latino (10.9, 95%CI:10.5–11.4) and non-Hispanic Black (6.2, 95%CI:6.0-6.4) SLE patients aged 20–49 had the highest CVE prevalence ratios. These population-based estimates of CVE in a diverse registry of patients with SLE revealed increased rates among younger male, Hispanic/Latino and non-Hispanic Black patients. These findings reinforce the need to appropriately screen for CVD among all SLE patients but particularly among these high-risk patients.

中文翻译：

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基于人群的系统性红斑狼疮患者登记中心血管事件的患病率


曼哈顿狼疮监测计划 (MLSP) 是一项基于人群的系统性红斑狼疮 (SLE) 患者回顾性登记，用于调查心血管疾病事件 (CVE) 的患病率，并比较性别、年龄和种族/民族之间的发生率基于人口的控制。 MLSP 中纳入了 2007 年流行的 SLE 且年龄≥20 岁的患者。 CVE 需要提供心肌梗塞或脑血管意外的记录。我们计算了粗风险比和调整后的风险比（ARR），控制了性别、年龄组、种族和民族以及诊断后的年数。使用 2009-2010 年国家健康与营养检查调查 (NHANES) 和 2013-2014 年纽约市健康与营养检查调查 (NYC HANES) 的数据，通过将 NHANES 和 NYC HANES 估计值乘以分层特定计数来计算预期 CVE 患病率。系统性红斑狼疮患者。使用国家和纽约市估计值计算粗患病率 (PR)，并使用国家估计值计算年龄标准化患病率 (ASPR)。 1,285 名患有 SLE 的 MLSP 患者中，13.9% 发生 CVE，男性 (ARR:1.7, 95%CI:1.2–2.5) 和老年人 (年龄 > 60 ARR:2.5, 95%CI:1.7–3.8) 的风险增加）。与非西班牙裔亚裔患者相比，西班牙裔/拉丁裔 (ARR:3.1, 95%CI:1.4-7.0) 和非西班牙裔黑人 (ARR:3.5, 95%CI1.6-7.9) 患者的 CVE 风险也较高那些被确定为非西班牙裔且属于另一个或多个种族群体的人（ARR：4.2，95％CI：1.1–15.8）。总体而言，SLE 患者的 CVE 患病率高于全国范围（ASPR：3.1，95% CI：3.0-3.1），但性别之间没有差异。与国家种族和民族分层估计值相比，SLE 患者的 CVE 在西班牙裔/拉丁裔中最高 (ASPR:4.3, 95%CI:4.2–4.4)。 与所有纽约市居民相比，SLE 登记患者的 CVE 也有所升高。与按年龄分层的全国估计值进行比较显示，20-49 岁患者的 PR 为 6.4（95%CI：6.2-6.5），≥ 50 岁患者的 PR 为 2.2（95%CI：2.1-2.2）。 20-49岁的男性（11.3，95%CI：10.5-12.1）、西班牙裔/拉丁裔（10.9，95%CI：10.5-11.4）和非西班牙裔黑人（6.2，95%CI：6.0-6.4）患有SLE CVE 患病率最高。这些基于人群的 SLE 患者登记中的 CVE 估计结果显示，年轻男性、西班牙裔/拉丁裔和非西班牙裔黑人患者的 CVE 发生率有所增加。这些发现强调了在所有 SLE 患者中适当筛查 CVD 的必要性，特别是在这些高危患者中。