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Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
The Korean Journal of Internal Medicine ; : 232-241, 2015.
Article Dans Anglais | WPRIM | ID: wpr-93733
ABSTRACT
BACKGROUND/

AIMS:

We investigated whether transthoracic echocardiography-suspected pulmonary hypertension (PH) affects survival in systemic lupus erythematosus (SLE) patients and examined factors associated with PH occurrence and survival.

METHODS:

This retrospective single-center study included 154 Korean SLE patients fulfilling the American College of Rheumatology criteria (January 1995 to June 2013). Student t test, Mann-Whitney U test, Kaplan-Meier curves, and log-rank tests were used for comparisons.

RESULTS:

A total of 35 SLE patients with PH (SLE/PH+) and 119 without PH (SLE/PH-) were analyzed. Higher percentages of interstitial lung disease, Raynaud's phenomenon (RP), World Health Organization functional classification III/IV, and cardiomegaly were found in SLE/PH+ compared to SLE/PH-. Furthermore, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was significantly higher in SLE/PH+ (2.46 +/- 1.245 vs. 1.00 +/- 1.235), whereas survival rates were significantly higher in SLE/PH- in log-rank tests (p = 0.001). In multivariate analysis, the adjusted mortality hazard ratio (HR) for SLE/PH+ patients was 3.10. Subgroup analysis demonstrated a higher percentage of lupus nephritis in the SLE/PH+ patients who died (p = 0.039) and low complement-3 levels (p = 0.007). In univariate analysis, the mortality HR for SLE/PH+ patients with lupus nephritis was 4.62, whereas the presence of RP decreased the mortality risk in multivariate analysis; adjusted HR, 0.10.

CONCLUSIONS:

PH is an independent factor predicting survival in SLE patients. The presence of lupus nephritis resulted in an increased trend for mortality, whereas coexistence of RP was associated with a better survival prognosis in SLE/PH+ patients.
Sujets)

Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Pronostic / Maladie de Raynaud / Glomérulonéphrite lupique / Loi du khi-deux / Modèles des risques proportionnels / Analyse multifactorielle / Études rétrospectives / Facteurs de risque / Cardiomégalie / Pneumopathies interstitielles Type d'étude: Etude d'étiologie / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Adolescent / Adulte / Femelle / Humains / Mâle Pays comme sujet: Asie langue: Anglais Texte intégral: The Korean Journal of Internal Medicine Année: 2015 Type: Article

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Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Pronostic / Maladie de Raynaud / Glomérulonéphrite lupique / Loi du khi-deux / Modèles des risques proportionnels / Analyse multifactorielle / Études rétrospectives / Facteurs de risque / Cardiomégalie / Pneumopathies interstitielles Type d'étude: Etude d'étiologie / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Adolescent / Adulte / Femelle / Humains / Mâle Pays comme sujet: Asie langue: Anglais Texte intégral: The Korean Journal of Internal Medicine Année: 2015 Type: Article