■系统性红斑狼疮患者容易发生心血管疾病(CVD),并增加了发病率和死亡率。
■我们对狼疮性肾炎患者进行了回顾性分析,以评估主要不良心血管事件(MACE)的发生和预测因素。数据收集自2005年至2020年期间接受肾活检的患者。进行统计分析以揭示相关性。
■在这一时期对91例患者进行了分析,平均年龄为37.3±12.3岁,86%为女性。平均随访时间为62±48个月。15.38%的患者至少经历过一次MACE。两名死于CVD的患者。年龄增加(35.81±11.14vs45.5±15.11岁,p=0.012)需要更高的MACE发生率。中性粒细胞计数(5.15±2.83vs7.3±2.99Giga/L,p=0.001)更高,而舒张压(DBP)较低(89.51±10.96vs78.43±6.9mmHg,p<0.001)在MACE患者活检时。年龄,中性粒细胞计数,DBP被证明是MACE的独立预测因子。我们提出了一种新的模型(CANDE-基于年龄的心血管风险,中性粒细胞计数,和舒张压估计评分)根据这些变量计算,预测MACE发生的概率。
■这项研究强调了在这个脆弱的患者群体中积极筛查心血管风险的重要性。年龄,中性粒细胞计数,和舒张压已被确定为狼疮性肾炎MACE的独立危险因素。从这些参数得出的CANDE分数可以作为提示,成本效益高,和易于获得的估计工具,用于评估主要不良心血管风险的可能性。这些发现强调了针对系统性红斑狼疮患者免疫失调和心血管危险因素的综合管理策略的必要性,以减轻不良结局。
UNASSIGNED: Patients with systemic lupus erythematosus are prone to develop cardiovascular disease (CVD), and have increased morbidity and mortality.
UNASSIGNED: We conducted a retrospective analysis on lupus nephritis patients to assess the occurrence and predictors of major adverse cardiovascular events (MACE). Data were collected from patients who underwent kidney biopsy between 2005 and 2020. Statistical analysis was performed to unveil correlations.
UNASSIGNED: 91 patients were analyzed in this period, with a mean age of 37.3 ± 12.3 years and 86% being female. The mean follow-up time was 62 ± 48 months. 15.38% of the patients underwent at least one MACE. Two patients deceased of CVD. Increased age (35.81 ± 11.14 vs 45.5 ± 15.11 years, p=0.012) entailed a higher occurrence of MACEs. Neutrophil count (5.15 ± 2.83 vs 7.3 ± 2.99 Giga/L, p=0.001) was higher, whereas diastolic blood pressure (DBP) was lower (89.51 ± 10.96 vs 78.43 ± 6.9 mmHg, p<0.001) at the time of the biopsy in patients with MACE. Age, neutrophil count, and DBP proved to be independent predictors of MACEs. We propose a new model (CANDE - Cardiovascular risk based on Age, Neutrophil count, and Diastolic blood pressure Estimation score) calculated from these variables, which predicts the probability of MACE occurrence.
UNASSIGNED: This study underscores the importance of actively screening for cardiovascular risks in this vulnerable patient population. Age, neutrophil count, and diastolic blood pressure have been established as independent risk factors for MACE in lupus nephritis. The CANDE score derived from these parameters may serve as a prompt, cost-effective, and easily accessible estimation tool for assessing the likelihood of major adverse cardiovascular risk. These findings emphasize the necessity for comprehensive management strategies addressing both immune dysregulation and cardiovascular risk factors in systemic lupus erythematosus to mitigate adverse outcomes.