What are the common causes of late deaths in individuals with systemic lupus erythematosus (SLE)?

Updated: Aug 04, 2021
  • Author: Christie M Bartels, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Late deaths (after age 35 years) are generally from myocardial infarction or stroke secondary to accelerated atherosclerosis. [65, 73, 66, 74]  Inflammation is central to SLE pathogenesis and plays a major role in the development and accelerated progression of atherosclerosis. Manzi et al reported that women aged 35-44 years with SLE were 50 times more likely to develop myocardial ischemia than healthy Framingham study control women. [73] The presence of lupus nephritis may increase these risks. [75] The presence of traditional and nontraditional risk factors increases the risk of cardiovascular (CVD) disease in patients with SLE.

In a study by Petri et al that evaluated a large sample of SLE patients, the investigators reported that more than 50% of these patients had at least 3 classic cardiac risk factors, with the most common ones being a sedentary lifestyle, obesity, and hypercholesterolemia. [76] In another study, Salmon et al found that nontraditional CVD risk factors in SLE patients included having higher homocysteine levels, renal impairment, enhanced LDL oxidation, and chronic inflammation. [77]


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