Cardiovascular risk stratification and appropriate use of statins in patients with systemic lupus erythematosus according to different strategies
Introduction/objectives Cardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular risk by different strategies in patients with SLE, analyzing which proportion of patients would be candidates to receiv...
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Published in | Clinical rheumatology Vol. 39; no. 2; pp. 455 - 462 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
London
Springer London
01.02.2020
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
ISSN | 0770-3198 1434-9949 1434-9949 |
DOI | 10.1007/s10067-019-04856-z |
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Abstract | Introduction/objectives
Cardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular risk by different strategies in patients with SLE, analyzing which proportion of patients would be candidates to receive statin therapy, and identify how many patients with statin indication received such drugs.
Method
A cross-sectional study was performed from a secondary database. Following the recommendations of National Institute for Health and Care Excellence (NICE) guidelines and the Argentine Consensus, the QRISK-3 and the adjusted Framingham (multiplying factor × 2) scores were calculated in primary prevention subjects. The indications for statin therapy according to these recommendations were analyzed.
Results
In total, 110 patients were included. Regarding patients without previous cardiovascular history, the median adjusted Framingham score was 12.8% (4.1–21.9), and 45.2%, 22.6%, and 32.2% of them were classified at low, moderate, or high risk. The median QRISK-3 score was 6.0% (2.1–14.1) and 42.1% of subjects were classified “at risk”. Only 60% of subjects in secondary prevention received statins, although no patient received the recommended doses. Analyzing patients in primary prevention who did not receive statins (87%), 43.4% and 45.2% of the patients were eligible for statin therapy according to NICE guidelines and Argentine Consensus, respectively.
Conclusions
Our findings showed that a large proportion of patients with SLE have a considerable cardiovascular risk and many of them would be eligible for statin therapy. However, the statin use observed was low.
Key Points
• A large proportion of patients with lupus have a considerable cardiovascular risk, explained in part by dyslipidemia.
• Many patients with SLE would be eligible for statin therapy according to risk stratification based on conventional risk factors.
• The use of statins in this population is inadequate. |
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AbstractList | Cardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular risk by different strategies in patients with SLE, analyzing which proportion of patients would be candidates to receive statin therapy, and identify how many patients with statin indication received such drugs.
A cross-sectional study was performed from a secondary database. Following the recommendations of National Institute for Health and Care Excellence (NICE) guidelines and the Argentine Consensus, the QRISK-3 and the adjusted Framingham (multiplying factor × 2) scores were calculated in primary prevention subjects. The indications for statin therapy according to these recommendations were analyzed.
In total, 110 patients were included. Regarding patients without previous cardiovascular history, the median adjusted Framingham score was 12.8% (4.1-21.9), and 45.2%, 22.6%, and 32.2% of them were classified at low, moderate, or high risk. The median QRISK-3 score was 6.0% (2.1-14.1) and 42.1% of subjects were classified "at risk". Only 60% of subjects in secondary prevention received statins, although no patient received the recommended doses. Analyzing patients in primary prevention who did not receive statins (87%), 43.4% and 45.2% of the patients were eligible for statin therapy according to NICE guidelines and Argentine Consensus, respectively.
Our findings showed that a large proportion of patients with SLE have a considerable cardiovascular risk and many of them would be eligible for statin therapy. However, the statin use observed was low.Key Points• A large proportion of patients with lupus have a considerable cardiovascular risk, explained in part by dyslipidemia.• Many patients with SLE would be eligible for statin therapy according to risk stratification based on conventional risk factors.• The use of statins in this population is inadequate. Cardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular risk by different strategies in patients with SLE, analyzing which proportion of patients would be candidates to receive statin therapy, and identify how many patients with statin indication received such drugs.INTRODUCTION/OBJECTIVESCardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular risk by different strategies in patients with SLE, analyzing which proportion of patients would be candidates to receive statin therapy, and identify how many patients with statin indication received such drugs.A cross-sectional study was performed from a secondary database. Following the recommendations of National Institute for Health and Care Excellence (NICE) guidelines and the Argentine Consensus, the QRISK-3 and the adjusted Framingham (multiplying factor × 2) scores were calculated in primary prevention subjects. The indications for statin therapy according to these recommendations were analyzed.METHODA cross-sectional study was performed from a secondary database. Following the recommendations of National Institute for Health and Care Excellence (NICE) guidelines and the Argentine Consensus, the QRISK-3 and the adjusted Framingham (multiplying factor × 2) scores were calculated in primary prevention subjects. The indications for statin therapy according to these recommendations were analyzed.In total, 110 patients were included. Regarding patients without previous cardiovascular history, the median adjusted Framingham score was 12.8% (4.1-21.9), and 45.2%, 22.6%, and 32.2% of them were classified at low, moderate, or high risk. The median QRISK-3 score was 6.0% (2.1-14.1) and 42.1% of subjects were classified "at risk". Only 60% of subjects in secondary prevention received statins, although no patient received the recommended doses. Analyzing patients in primary prevention who did not receive statins (87%), 43.4% and 45.2% of the patients were eligible for statin therapy according to NICE guidelines and Argentine Consensus, respectively.RESULTSIn total, 110 patients were included. Regarding patients without previous cardiovascular history, the median adjusted Framingham score was 12.8% (4.1-21.9), and 45.2%, 22.6%, and 32.2% of them were classified at low, moderate, or high risk. The median QRISK-3 score was 6.0% (2.1-14.1) and 42.1% of subjects were classified "at risk". Only 60% of subjects in secondary prevention received statins, although no patient received the recommended doses. Analyzing patients in primary prevention who did not receive statins (87%), 43.4% and 45.2% of the patients were eligible for statin therapy according to NICE guidelines and Argentine Consensus, respectively.Our findings showed that a large proportion of patients with SLE have a considerable cardiovascular risk and many of them would be eligible for statin therapy. However, the statin use observed was low.Key Points• A large proportion of patients with lupus have a considerable cardiovascular risk, explained in part by dyslipidemia.• Many patients with SLE would be eligible for statin therapy according to risk stratification based on conventional risk factors.• The use of statins in this population is inadequate.CONCLUSIONSOur findings showed that a large proportion of patients with SLE have a considerable cardiovascular risk and many of them would be eligible for statin therapy. However, the statin use observed was low.Key Points• A large proportion of patients with lupus have a considerable cardiovascular risk, explained in part by dyslipidemia.• Many patients with SLE would be eligible for statin therapy according to risk stratification based on conventional risk factors.• The use of statins in this population is inadequate. Introduction/objectivesCardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular risk by different strategies in patients with SLE, analyzing which proportion of patients would be candidates to receive statin therapy, and identify how many patients with statin indication received such drugs.MethodA cross-sectional study was performed from a secondary database. Following the recommendations of National Institute for Health and Care Excellence (NICE) guidelines and the Argentine Consensus, the QRISK-3 and the adjusted Framingham (multiplying factor × 2) scores were calculated in primary prevention subjects. The indications for statin therapy according to these recommendations were analyzed.ResultsIn total, 110 patients were included. Regarding patients without previous cardiovascular history, the median adjusted Framingham score was 12.8% (4.1–21.9), and 45.2%, 22.6%, and 32.2% of them were classified at low, moderate, or high risk. The median QRISK-3 score was 6.0% (2.1–14.1) and 42.1% of subjects were classified “at risk”. Only 60% of subjects in secondary prevention received statins, although no patient received the recommended doses. Analyzing patients in primary prevention who did not receive statins (87%), 43.4% and 45.2% of the patients were eligible for statin therapy according to NICE guidelines and Argentine Consensus, respectively.ConclusionsOur findings showed that a large proportion of patients with SLE have a considerable cardiovascular risk and many of them would be eligible for statin therapy. However, the statin use observed was low.Key Points• A large proportion of patients with lupus have a considerable cardiovascular risk, explained in part by dyslipidemia.• Many patients with SLE would be eligible for statin therapy according to risk stratification based on conventional risk factors.• The use of statins in this population is inadequate. Introduction/objectives Cardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular risk by different strategies in patients with SLE, analyzing which proportion of patients would be candidates to receive statin therapy, and identify how many patients with statin indication received such drugs. Method A cross-sectional study was performed from a secondary database. Following the recommendations of National Institute for Health and Care Excellence (NICE) guidelines and the Argentine Consensus, the QRISK-3 and the adjusted Framingham (multiplying factor × 2) scores were calculated in primary prevention subjects. The indications for statin therapy according to these recommendations were analyzed. Results In total, 110 patients were included. Regarding patients without previous cardiovascular history, the median adjusted Framingham score was 12.8% (4.1–21.9), and 45.2%, 22.6%, and 32.2% of them were classified at low, moderate, or high risk. The median QRISK-3 score was 6.0% (2.1–14.1) and 42.1% of subjects were classified “at risk”. Only 60% of subjects in secondary prevention received statins, although no patient received the recommended doses. Analyzing patients in primary prevention who did not receive statins (87%), 43.4% and 45.2% of the patients were eligible for statin therapy according to NICE guidelines and Argentine Consensus, respectively. Conclusions Our findings showed that a large proportion of patients with SLE have a considerable cardiovascular risk and many of them would be eligible for statin therapy. However, the statin use observed was low. Key Points • A large proportion of patients with lupus have a considerable cardiovascular risk, explained in part by dyslipidemia. • Many patients with SLE would be eligible for statin therapy according to risk stratification based on conventional risk factors. • The use of statins in this population is inadequate. |
Author | Scolnik, Marina Gago, Mariela Alvarado, Rodolfo N. Cornejo-Peña, Guillermo Masson, Walter Rossi, Emiliano Pessio, Carla Mora-Crespo, Lorena M. |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31802350$$D View this record in MEDLINE/PubMed |
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Copyright | International League of Associations for Rheumatology (ILAR) 2019 Clinical Rheumatology is a copyright of Springer, (2019). All Rights Reserved. |
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erythematosus publication-title: Lupus doi: 10.1177/0961203310364400 – volume: 26 start-page: 1407 year: 2017 end-page: 1419 ident: CR1 article-title: Management of cardiovascular risk in systemic lupus erythematosus: a systematic review publication-title: Lupus doi: 10.1177/0961203317704710 – volume: 94 year: 2015 ident: CR4 article-title: Cardiovascular events in systemic lupus erythematosus: a nationwide study in Spain from the RELESSER registry publication-title: Medicine (Baltimore) doi: 10.1097/MD.0000000000001183 – volume: 43 start-page: 875 year: 2016 end-page: 879 ident: CR25 article-title: Modified Framingham risk factor score for systemic lupus erythematosus publication-title: J Rheumatol doi: 10.3899/jrheum.150983 – volume: 4 issue: 1 year: 2017 ident: CR8 article-title: Cardiovascular risk profiles in a lupus cohort: what do different calculators tell us? publication-title: Lupus Sci Med doi: 10.1136/lupus-2017-000212 – volume: 56 start-page: 709 year: 2017 end-page: 715 ident: CR18 article-title: The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis: a Danish nationwide population-based cohort study publication-title: Rheumatology (Oxford) – volume: 56 start-page: 1384 year: 2007 end-page: 1396 ident: CR22 article-title: Premature atherosclerotic cardiovascular disease in systemic lupus erythematosus publication-title: Arthritis Rheum doi: 10.1002/art.22568 – volume: 26 start-page: 95 year: 2012 end-page: 101 ident: CR21 article-title: Prevalence and correlation of conventional and lupus-specific risk factors for cardiovascular disease in Chinese systemic lupus erythematosus patients publication-title: J Eur Acad Dermatol Venereol doi: 10.1111/j.1468-3083.2011.04211.x – volume: 44 start-page: 2331 year: 2001 ident: 4856_CR2 publication-title: Arthritis Rheum doi: 10.1002/1529-0131(200110)44:10<2331::AID-ART395>3.0.CO;2-I – volume: 94 year: 2015 ident: 4856_CR4 publication-title: Medicine 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Cardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to... Cardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to estimate the cardiovascular... Introduction/objectivesCardiovascular risk management of patients with systemic lupus erythematosus (SLE) is medically relevant. The objectives were to... |
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SubjectTerms | Adult Aged Cardiovascular diseases Cardiovascular Diseases - etiology Cardiovascular Diseases - prevention & control Cross-Sectional Studies Dyslipidemia Female Guideline Adherence - statistics & numerical data Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Lupus Lupus Erythematosus, Systemic - complications Male Medicine Medicine & Public Health Metabolic disorders Middle Aged Original Article Practice Guidelines as Topic Rheumatology Risk Assessment Risk factors Statins Systemic lupus erythematosus |
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Title | Cardiovascular risk stratification and appropriate use of statins in patients with systemic lupus erythematosus according to different strategies |
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