Higher Risk of Stroke, Heart Attack in Patients With Systemic Lupus Erythematosus

Adult patients with systemic lupus erythematosus had a significantly greater risk of stroke and myocardial infarction compared to the general population, according to findings published in RMD Open.

Researchers conducted a meta-analysis using observational studies that evaluated risk of stroke and myocardial infarction and were published in MEDLINE and EMBASE. Data was collected from inception through May 2020.

The meta-analysis included 26 studies, of which 14 involved stroke, 5 involved myocardial infarction, and 7 involved both stroke and myocardial infarction.

Pooled risk ratios were:

• 2.18 for ischemic stroke (95% CI 1.78 to 2.67; I² 75%);
• 1.84 for intracerebral hemorrhage (95% CI 1.16 to 2.90; I² 67%);
• 1.95 for subarachnoid hemorrhage (95% CI 0.69 to 5.52; I² 94%);
• 2.13 for composite stroke (95% CI 1.73 to 2.61; I² 88%); and
• 2.99 for myocardial infarction (95% CI 2.34 to 3.82; I² 85%).
• Researchers noted that patients with systemic lupus erythematosus were 2 to 3 times more likely to be at risk of stroke or heart attack than the general population or healthy controls.

“Future research on the interaction between known [systemic lupus erythematosus]-specific modifiable risk factors and risk of stroke and [myocardial infarction] to support development of prevention and treatment strategies are needed,” authors concluded.

Reference:
Yazdany J, Pooley N, Langham J, et al. Systemic lupus erythematosus; stroke and myocardial infarction risk: A systematic review and meta-analysis. RMD Open. 2021;6(2):e001247. doi:10.1136/rmdopen-2020-001247