Antimalarials exert a cardioprotective effect in lupus patients: Insights from the Spanish Society of Rheumatology Lupus Register (RELESSER) analysis of factors associated with heart failure.
Por:
Rúa-Figueroa I, Rúa-Figueroa D, Pérez-Veiga N, Anzola AM, Galindo-Izquierdo M, Calvo-Alén J, Fernández-Nebro A, Sangüesa C, Menor-Almagro R, Tomero E, Del Val N, Uriarte-Isazelaya E, Blanco R, Andreu JL, Boteanu A, Narváez J, Cobo T, Bohórquez C, Montilla C, Salas E, Toyos FJ, Bernal JA, Salgado E, Freire M, Mas AJ, Expósito L, Hernández-Beriain JA, Ibarguengoitia O, Velloso-Feijoo ML, Lozano-Rivas N, Bonilla G, Moreno M, Jiménez I, Quevedo-Vila V, Pecondón A, Aurrecoechea E, Valls E, Mouriño C, Vázquez-Rodríguez T and Pego-Reigosa JM
Publicada:
1 feb 2022
Ahead of Print:
2 ene 2022
Resumen:
BACKGROUND/OBJECTIVES: Factors associated with chronic heart failure (CHF) in patients with systemic lupus erythematosus (SLE) have received little attention. Recent data on the use of hydroxychloroquine in the treatment of SARS-CoV-2 infection have cast doubt on its cardiac safety. The factors associated with CHF, including therapy with antimalarials, were analyzed in a large multicenter SLE cohort. METHODS: Cross-sectional study including all patients with SLE (ACR-1997 criteria) included in the Spanish Society of Rheumatology Lupus Register (RELESSER), based on historically gathered data. Patients with CHF prior to diagnosis of SLE were excluded. A multivariable analysis exploring factors associated with CHF was conducted. RESULTS: The study population comprised 117 patients with SLE (ACR-97 criteria) and CHF and 3,506 SLE controls. Ninety percent were women. Patients with CHF were older and presented greater SLE severity, organ damage, and mortality than those without CHF. The multivariable model revealed the factors associated with CHF to be ischemic heart disease (7.96 [4.01-15.48], p < 0.0001), cardiac arrhythmia (7.38 [4.00-13.42], p < 0.0001), pulmonary hypertension (3.71 [1.84-7.25], p < 0.0002), valvulopathy (6.33 [3.41-11.62], p < 0.0001), non-cardiovascular damage (1.29 [1.16-1.44], p < 0.000) and calcium/vitamin D treatment (5.29 [2.07-16.86], p = 0.0015). Female sex (0.46 [0.25-0.88], p = 0.0147) and antimalarials (0.28 [0.17-0.45], p < 0.000) proved to be protective factors. CONCLUSIONS: Patients with SLE and CHF experience more severe SLE. Treatment with antimalarials appears to confer a cardioprotective effect.
Filiaciones:
Rúa-Figueroa I:
Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas GC, Spain. Electronic address:
Rúa-Figueroa D:
Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas GC, Spain
Pérez-Veiga N:
Galicia Sur Health Research Institute, Vigo, Spain
Anzola AM:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Galindo-Izquierdo M:
Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain. Electronic address:
Calvo-Alén J:
Hospital Universitario Araba, País Vasco, Spain
Fernández-Nebro A:
Hospital Universitario de Málaga, Málaga, Spain
Sangüesa C:
Hospital Germán Trias i Pujol, Barcelona, Spain
Menor-Almagro R:
Hospital Jerez de la Frontera, Cádiz, Spain
Tomero E:
Hospital de La Princesa, Madrid, Spain
Del Val N:
Hospital de Navarra, Pamplona, Spain
Uriarte-Isazelaya E:
Hospital de Donostia, San Sebastián, Spain
Blanco R:
Hospital Universitario Marqués de Valdecilla, Santander, Spain
Andreu JL:
Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
Boteanu A:
Hospital Ramón y Cajal, Madrid, Spain
Narváez J:
Hospital Universitari de Bellvitge, Barcelona, Spain
Cobo T:
Hospital Infanta Sofía, Madrid, Spain
Bohórquez C:
Hospital Universitario Príncipe de Asturias (Alcalá de Henares), Madrid, Spain
Montilla C:
Hospital Clínico de Salamanca, Salamanca, Spain
Salas E:
Hospital Marina Baixa, Villajoyosa, Alicante, Spain
Toyos FJ:
Hospital Universitario Virgen Macarena, Sevilla, Spain
:
Hospital General Universitario de Alicante, Alicante, Spain
Salgado E:
Complejo Hospitalario De Orense, Orense, Spain
Freire M:
Hospital Juan Canalejo de la Coruña, A Coruña, Spain
Mas AJ:
Hospital Son Llátzer, Palma de Mallorca, Spain
Expósito L:
Hospital Universitario de Canarias, La Laguna (Tenerife), Spain
Hernández-Beriain JA:
Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain. Electronic address:
Ibarguengoitia O:
Hospital de Basurto, Bilbao, Spain
Velloso-Feijoo ML:
Hospital Virgen de Valme, Sevilla, Spain
Lozano-Rivas N:
Hospital Virgen de la Arrixaca, Murcia, Spain
Bonilla G:
Hospital Universitario La Paz, Madrid, Spain
Moreno M:
Hospital de Sabadell, Barcelona, Spain
Jiménez I:
Hospital Universitario San Cecilio, Granada, Spain
Quevedo-Vila V:
Hospital Comarcal de Monforte, Lugo, Spain
Pecondón A:
Hospital Universitario Miguel Servet, Zaragoza, Spain
Aurrecoechea E:
Hospital Sierrallana, Torrelavega, Spain
Valls E:
Hospital Universitario Doctor Peset, Valencia, Spain
Mouriño C:
Galicia Sur Health Research Institute, Vigo, Spain
Vázquez-Rodríguez T:
Hospital Lucus Augusti, Lugo, Spain
Pego-Reigosa JM:
Complexo Hospitalario Universitario de Vigo, Spain
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