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 inClinical rheumatology Vol. 39; no. 2; pp. 455 - 462
Main Authors Masson, Walter, Rossi, Emiliano, Mora-Crespo, Lorena M., Cornejo-Peña, Guillermo, Pessio, Carla, Gago, Mariela, Alvarado, Rodolfo N., Scolnik, Marina
Format Journal Article
LanguageEnglish
Published London Springer London 01.02.2020
Springer Nature B.V
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ISSN0770-3198
1434-9949
1434-9949
DOI10.1007/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.
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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Systemic lupus erythematosus
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PublicationSubtitle Journal of the International League of Associations for Rheumatology
PublicationTitle Clinical rheumatology
PublicationTitleAbbrev Clin Rheumatol
PublicationTitleAlternate Clin Rheumatol
PublicationYear 2020
Publisher Springer London
Springer Nature B.V
Publisher_xml – name: Springer London
– name: Springer Nature B.V
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Snippet Introduction/objectives 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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pubmed
crossref
springer
SourceType Aggregation Database
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Enrichment Source
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StartPage 455
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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https://www.ncbi.nlm.nih.gov/pubmed/31802350
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