Researchers have uncovered that positive antiphospholipid antibodies may be associated with an increased risk of atherosclerotic cardiovascular disease in patients with systemic lupus erythematosus, according to a press release from the ACR. Previous studies have demonstrated that patients with lupus may be at an increased risk of cardiovascular disease and that antiphospholipid antibodies may be linked to heart attack, stroke, and pulmonary embolism in pregnant patients. In a new study—presented by Ding et al at ACR Convergence 2023—researchers used the Chinese SLE Treatment and Research Group to examine the outcomes of 1,500 patients diagnosed with lupus between 2006 and 2021. The researchers measured their antiphospholipid antibody isotopes at diagnosis and after a follow-up period, including anticardiolipin antibodies, anti–beta-2–glycoprotein I antibodies, and lupus anticoagulants. Among the 33.4% (n = 525) of patients who had positive antiphospholipid antibodies, lupus anticoagulants (20.6%) were most prevalent, followed by anticardiolipin antibodies (15.8%). After a follow-up of 4.5 years, 7.37% (n = 116) of patients—79% (n = 92) of whom had positive antiphospholipid antibodies—developed atherosclerotic cardiovascular disease, such as nonfatal heart attack, nonfatal stroke, coronary or peripheral artery revascularization, or cardiovascular mortality. The researchers underscored that anticardiolipin immunoglobulin G; anticardiolipin immunoglobulin M; lupus anticoagulants; and risk factors such as smoking, hypertension, and gender and age were independently associated with atherosclerotic cardiovascular disease. They suggested that treatment with anticoagulants and antiplatelets may reduce the risk of cardiovascular disease in this patient population, and concluded that patients with lupus should undergo testing and surveillance for cardiovascular disease.
November 22, 2023