Future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on CSTAR (XXVIII): the effect of different antiphospholipid antibodies isotypes
Abstract Background Patients with systemic lupus erythematosus (SLE) suffered from an increasing risk of cardiovascular diseases. In this multi-center prospective study, we aimed to determine the association between antiphospholipid antibodies (aPLs) and future atherosclerotic cardiovascular disease...
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2025-01-01
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| author | Can Huang Yufang Ding Zhen Chen Lijun Wu Wei Wei Cheng Zhao Min Yang Shudian Lin Qian Wang Xinping Tian Jiuliang Zhao Mengtao Li Xiaofeng Zeng |
| author_facet | Can Huang Yufang Ding Zhen Chen Lijun Wu Wei Wei Cheng Zhao Min Yang Shudian Lin Qian Wang Xinping Tian Jiuliang Zhao Mengtao Li Xiaofeng Zeng |
| author_sort | Can Huang |
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| description | Abstract Background Patients with systemic lupus erythematosus (SLE) suffered from an increasing risk of cardiovascular diseases. In this multi-center prospective study, we aimed to determine the association between antiphospholipid antibodies (aPLs) and future atherosclerotic cardiovascular disease (ASCVD) in SLE. Methods In total, 1573 SLE patients were recruited based on the Chinese SLE Treatment and Research group (CSTAR) registry. aPLs profile, including anticardiolipin antibodies (aCL) IgG/IgM, anti-β2 glycoprotein I antibodies (aβ2GPI) IgG/IgM, and lupus anticoagulant (LA), were measured in each center. Future ASCVD events were defined as new-onset myocardial infarction, stroke, artery revascularization, or cardiovascular death. Results Among the 1573 SLE patients, 525 (33.4%) had positive aPLs. LA had the highest prevalence (324 [20.6%]), followed by aCL IgG (249 [15.8%]), aβ2GPI IgG (199 [12.7%]). 116 (7.37%) patients developed ASCVD during the mean follow-up of 4.51 ± 2.32 years and 92 patients were aPLs positive. In univariate Cox regression analysis, both aPLs (HR = 7.81, 95% CI 5.00–12.24, p < 0.001) and traditional risk factors of cardiovascular disease were associated with future ASCVD events. In multiple Cox regression analysis, aCL IgG (HR = 1.95, 95% CI 1.25–3.00, p = 0.003), aCL IgM (HR = 1.83, 95% CI 1.03–3.20, p = 0.039), and LA (HR = 5.13, 95% CI 3.23–8.20, p < 0.001) positivity remained associated with ASCVD; traditional risk factors for ASCVD, including smoking, gender, age and hypertension, also play an independent role in SLE patients. More importantly, Aspirin can reduce ASCVD risk in SLE patients with positive aPLs (HR = 0.57 95% CI, 0.25–0.93, P = 0.026). Conclusions SLE patients with positive aPLs, especially positive aCL IgG/IgM and LA, warrant more care and surveillance of future ASCVD events during follow-up. Aspirin may have a protective effect on future ASCVD. |
| format | Article |
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| spelling | doaj-art-93a8a230b2e54cf6a1736f856408d58e2025-08-20T02:35:37ZengBMCBMC Medicine1741-70152025-01-0123111310.1186/s12916-024-03843-9Future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on CSTAR (XXVIII): the effect of different antiphospholipid antibodies isotypesCan Huang0Yufang Ding1Zhen Chen2Lijun Wu3Wei Wei4Cheng Zhao5Min Yang6Shudian Lin7Qian Wang8Xinping Tian9Jiuliang Zhao10Mengtao Li11Xiaofeng Zeng12Department of Rheumatology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of EducationDepartment of Rheumatology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of EducationDepartment of Rheumatology, The Second Affiliated Hospital of Fujian Medical UniversityDepartment of Rheumatology and Immunology, People’s Hospital of Xinjiang Uygur Autonomous RegionDepartment of Rheumatology and Immunology, Tianjin Medical University General HospitalDepartment of Rheumatology and Immunology, The People’s Hospital of Guangxi Zhuang Autonomous RegionDepartment of Rheumatic and TCM Medical Center, Nanfang Hospital, Southern Medical UniversityDepartment of Rheumatology and Immunology, Hainan General HospitalDepartment of Rheumatology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of EducationDepartment of Rheumatology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of EducationDepartment of Rheumatology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of EducationDepartment of Rheumatology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of EducationDepartment of Rheumatology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of EducationAbstract Background Patients with systemic lupus erythematosus (SLE) suffered from an increasing risk of cardiovascular diseases. In this multi-center prospective study, we aimed to determine the association between antiphospholipid antibodies (aPLs) and future atherosclerotic cardiovascular disease (ASCVD) in SLE. Methods In total, 1573 SLE patients were recruited based on the Chinese SLE Treatment and Research group (CSTAR) registry. aPLs profile, including anticardiolipin antibodies (aCL) IgG/IgM, anti-β2 glycoprotein I antibodies (aβ2GPI) IgG/IgM, and lupus anticoagulant (LA), were measured in each center. Future ASCVD events were defined as new-onset myocardial infarction, stroke, artery revascularization, or cardiovascular death. Results Among the 1573 SLE patients, 525 (33.4%) had positive aPLs. LA had the highest prevalence (324 [20.6%]), followed by aCL IgG (249 [15.8%]), aβ2GPI IgG (199 [12.7%]). 116 (7.37%) patients developed ASCVD during the mean follow-up of 4.51 ± 2.32 years and 92 patients were aPLs positive. In univariate Cox regression analysis, both aPLs (HR = 7.81, 95% CI 5.00–12.24, p < 0.001) and traditional risk factors of cardiovascular disease were associated with future ASCVD events. In multiple Cox regression analysis, aCL IgG (HR = 1.95, 95% CI 1.25–3.00, p = 0.003), aCL IgM (HR = 1.83, 95% CI 1.03–3.20, p = 0.039), and LA (HR = 5.13, 95% CI 3.23–8.20, p < 0.001) positivity remained associated with ASCVD; traditional risk factors for ASCVD, including smoking, gender, age and hypertension, also play an independent role in SLE patients. More importantly, Aspirin can reduce ASCVD risk in SLE patients with positive aPLs (HR = 0.57 95% CI, 0.25–0.93, P = 0.026). Conclusions SLE patients with positive aPLs, especially positive aCL IgG/IgM and LA, warrant more care and surveillance of future ASCVD events during follow-up. Aspirin may have a protective effect on future ASCVD.https://doi.org/10.1186/s12916-024-03843-9Systemic lupus erythematosus (SLE)Antiphospholipid syndrome (APS)Antiphospholipid antibodies (aPLs)Atherosclerotic cardiovascular disease (ASCVD)Aspirin |
| spellingShingle | Can Huang Yufang Ding Zhen Chen Lijun Wu Wei Wei Cheng Zhao Min Yang Shudian Lin Qian Wang Xinping Tian Jiuliang Zhao Mengtao Li Xiaofeng Zeng Future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on CSTAR (XXVIII): the effect of different antiphospholipid antibodies isotypes BMC Medicine Systemic lupus erythematosus (SLE) Antiphospholipid syndrome (APS) Antiphospholipid antibodies (aPLs) Atherosclerotic cardiovascular disease (ASCVD) Aspirin |
| title | Future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on CSTAR (XXVIII): the effect of different antiphospholipid antibodies isotypes |
| title_full | Future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on CSTAR (XXVIII): the effect of different antiphospholipid antibodies isotypes |
| title_fullStr | Future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on CSTAR (XXVIII): the effect of different antiphospholipid antibodies isotypes |
| title_full_unstemmed | Future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on CSTAR (XXVIII): the effect of different antiphospholipid antibodies isotypes |
| title_short | Future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on CSTAR (XXVIII): the effect of different antiphospholipid antibodies isotypes |
| title_sort | future atherosclerotic cardiovascular disease in systemic lupus erythematosus based on cstar xxviii the effect of different antiphospholipid antibodies isotypes |
| topic | Systemic lupus erythematosus (SLE) Antiphospholipid syndrome (APS) Antiphospholipid antibodies (aPLs) Atherosclerotic cardiovascular disease (ASCVD) Aspirin |
| url | https://doi.org/10.1186/s12916-024-03843-9 |
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