Incidence and survival impact of pulmonary arterial hypertension among patients with systemic lupus erythematosus: a nationwide cohort study

doi:10.1186/s13075-019-1868-0

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Title:	Incidence and survival impact of pulmonary arterial hypertension among patients with systemic lupus erythematosus: a nationwide cohort study
Authors:	Hung-An Chen(陳宏安) Hsu, Tsai-Ching Yang, Su-Ching Weng, Chia-Tse Wu, Chun-Hsin Sun, Chien-Yao Lin, Chun-Yu
Contributors:	Chi Mei Med Ctr, Div Allergy Immunol Rheumatol Chia Nan Univ Pharm & Sci Chung Shan Med Univ, Inst Biochem Microbiol & Immunol Natl Tainan Inst Nursing, Dept Nursing Natl Cheng Kung Univ, Coll Med, Natl Cheng Kung Univ Hosp, Dept Internal Med
Keywords:	Pulmonary arterial hypertension Systemic lupus erythematosus Incidence Prognosis
Date:	2019-03
Issue Date:	2020-07-29 13:53:10 (UTC+8)
Publisher:	BMC
Abstract:	BackgroundNo population-based study has investigated the cumulative incidence of pulmonary arterial hypertension (PAH) in patients with newly diagnosed systemic lupus erythematosus (SLE) or the survival impact of PAH in this population.MethodWe used a nationwide database in Taiwan and enrolled incident SLE patients between January 1, 2000, and December 31, 2013. The cumulative incidence of PAH in the SLE patients and the survival of these patients were estimated by the Kaplan-Meier method. Potential predictors of the development of PAH were determined using a Cox proportional hazards regression model.ResultsOf 15,783 SLE patients, 336 (2.13%) developed PAH. The average interval from SLE diagnosis to PAH diagnosis was 3.66years (standard deviation [SD] 3.36, range 0.1 to 13.0years). Seventy percent of the patients developed PAH within 5years after SLE onset. The 3- and 5-year cumulative incidence of PAH were 1.2% and 1.8%, respectively. Systemic hypertension was an independent predictor of PAH occurrence among the SLE patients (adjusted hazard ratio 2.27, 95% confidence interval 1.59-2.97). The 1-, 3-, and 5-year survival rates of SLE patients following the diagnosis of PAH were 87.7%, 76.8%, and 70.1%, respectively.ConclusionsPAH is a rare complication of SLE and the majority of PAH cases occur within the first 5years following SLE diagnosis. Systemic hypertension may be a risk factor for PAH development in the SLE population. The overall 5-year survival rate after PAH diagnosis was 70.1%.
Relation:	Arthritis Research & the rapy, v.21, 82
Appears in Collections:	[Dept. of Recreation and Health-Care Management] Periodical Articles

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