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Risk factors of pulmonary arterial hypertension in patients with systemic lupus erythematosus

Part of: Surgery

Published online by Cambridge University Press:  08 March 2021

Yunxia Lei ,
Xiao Zhang Open the ORCID record for Xiao Zhang [Opens in a new window] ,
Yuan Feng ,
Jieying Wang  and
Riqiang Luo
Yunxia Lei
Affiliation:
Department of Rheumatology and Clinical Immunology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province510080, China
Xiao Zhang*
Affiliation:
Department of Rheumatology and Clinical Immunology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province510080, China
Yuan Feng
Affiliation:
Department of Rheumatology and Clinical Immunology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province510080, China
Jieying Wang
Affiliation:
Department of Rheumatology and Clinical Immunology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province510080, China
Riqiang Luo
Affiliation:
Department of Rheumatology and Clinical Immunology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province510080, China
*
Author for correspondence: Xiao Zhang, Department of Rheumatology and Clinical Immunology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, 22nd Floor, Main Building, No. 106 Zhongshan 2nd Road, Guangzhou, Guangdong Province510080, China. Tel: +86 020 83883539; Fax: 86-020-83883539. E-mail: zhang_xiao20@yeah.net
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Abstract

Objectives:

Pulmonary arterial hypertension symptoms in systemic lupus erythematosus patients are non-specific and early diagnosis and intervention are challenging. It remains essential to explore risk factors for pulmonary arterial hypertension in systemic lupus erythematosus patients to identify high risk patients and allow intensive monitoring.

Methods:

From January 2010 to December 2018, 84 patients with systemic lupus erythematosus and pulmonary arterial hypertension and 160 patients with systemic lupus erythematosus but without pulmonary arterial hypertension were enrolled. Clinical manifestations and laboratory test results were compared between the two groups to identify predictors of pulmonary arterial hypertension. Candidate pulmonary arterial hypertension risk factors were further compared among systemic lupus erythematosus-pulmonary arterial hypertension patients with different characteristics.

Results:

Among collected patient characteristics, Raynaud’s phenomenon (OR 2.32, 95% CI: 1.17–4.61), digital vasculitis (OR 4.12, 95% CI: 1.48–11.49), pericardial effusion, pulmonary interstitial lesions, positive anti-u1 ribonucleoprotein antibodies, and positive anticardiolipin antibodies immunoglobulin G were associated with significantly higher risk of pulmonary arterial hypertension in systemic lupus erythematosus patients. Among these candidate risk factors, positive anti-u1 ribonucleoprotein antibody was independently associated with severe pulmonary arterial hypertension and more active disease. Digital vasculitis was independently associated with systemic lupus erythematosus alleviation, while pericardial effusion was associated with systemic lupus erythematosus deterioration. Pericardial effusion was associated with longer pulmonary arterial hypertension duration.

Conclusion:

The significant association between studied clinical and laboratory indicators and risk of pulmonary arterial hypertension, pulmonary arterial hypertension and systemic lupus erythematosus characteristics suggested that these factors can be used to identify patients at higher risk of pulmonary arterial hypertension and adverse outcomes. Close monitoring may be indicated in patients with these risk factors, especially with more than one risk factor.

Keywords

Pulmonary arterial hypertensionsystemic lupus erythematosusrisk stratification
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 10 , October 2021 , pp. 1619 - 1624
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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