The risk of pulmonary embolism and deep venous thrombosis in systemic lupus erythematosus: A general population-based study

Abstract

Objective-To estimate the future risk and time trends of newly diagnosed venous thromboembolism (VTE) in individuals with incident systemic lupus erythematosus (SLE) in the general population.Methods-Using a population-based database that includes all residents of British Columbia, Canada we conducted a study cohort of all patients with incident SLE and up to 10 age-, sex-, and entry-time-matched individuals from the general population. We compared incidence rates of pulmonary embolism (PE), deep venous thrombosis (DVT) and VTE between the two groups according to SLE disease duration. We calculated hazards ratios (HR), adjusting for confounders.Results-Among 4,863 individuals with SLE (86% female, mean age 48.9 years), the incidence rates (IRs) of PE, DVT, and VTE were 2.58, 3.33, and 5.32 per 1000 person-years, respectively, whereas the corresponding rates in the comparison cohort were 0.67, 0.57, and 1.11 per 1000 person-years. Compared with non-SLE individuals, the multivariable HRs among SLE patients were 3.04 (95% CI, 2.08-4.45), 4.46 (95% CI, 3.11-6.41) and 3.55 (95% CI, 2.69-4.69), respectively. The age-, sex-, and entry time-matched HRs for PE, DVT and VTE were highest Contributors: JAA-Z secured the funding source, and contributed to study conception, study design, data analysis/interpretation, and critical review of the manuscript. KV and MDV contributed to data analysis/interpretation and drafted the manuscript. ES contributed to data analysis and manuscript preparation. HKC secured some of the funding sources, and contributed to study conception/design, data analysis/interpretation, and critical review of the manuscript. Conclusion-These findings provide population-based evidence that patients with SLE have a substantially increased risk of VTE, especially in the first year after SLE diagnosis. Awareness and increased vigilance of this potentially fatal, but preventable, complication is recommended.

Should We Screen Patients with Unprovoked Venous Thromboembolism for Hyperthyroidism? Report of Several Paradigmatic Clinical Cases from the RIETE Registry

“…According to this defi nition several studies record a nearly 40-50% of unprovoked VTE in real life [5] and according to common thrombotic risk factors suggested by guidelines 2014; yet other clinical conditions are well known as conditions that may predispose for VTE as infl ammatory bowel disease, immunopathological disease and/or connectivitis, nephritic syndrome and others [10][11][12].…”

“…However, several other clinical conditions may be associated with VTE but, are not usually considered for daily screening as a potential cause of VTE, nor are reported as common cause of VTE in large randomized clinical trials and registries including nephrotic syndrome, infl ammatory bowel disease, connectivitis and others [10][11][12].…”

Filling the gaps in SARDs research: collection and linkage of administrative health data and self-reported survey data for a general population-based cohort of individuals with and without diagnoses of systemic autoimmune rheumatic disease (SARDs) from British Columbia, Canada

“…Numerous general population-based studies have been successfully conducted using these databases. [23][24][25][26] Population-based cohorts From the administrative data files, we assembled a population-based cohort of all BC adults with SARDs during the years 1996-2010. SARDs cases were identified on the basis of International Classification of Diseases Ninth (ICD-9) and Tenth (ICD-10) Revision diagnostic codes (see online supplementary file) recorded for outpatient encounters and hospitalisations, having either: (A) ≥2 ICD-9 codes for SARDs ≥2 months apart but within a 2-year period by a non-rheumatologist physician; or (B) one ICD-9 or ICD-10 code for SARDs by a rheumatologist (at any time) or from hospitalisation.…”

A szisztémás lupus erythematosus pulmonalis manifesztációi

“…A pulmonalis embolia kockázata gyakoribb az átlagpo-pulációhoz képest, különösen az SLE diagnózisát követő egy éven belül [28]. Antifoszfolipid-szindrómával (APS) szövődött SLE-ben gyakoribb, ahol akár az antifoszfolipid-szindróma első pulmonalis manifesztációja lehet.…”