Prevalence, clinical features, risk factors, and outcomes of SLE patients with aortic aneurysm: a cross-sectional retrospective study in a Chinese single center

Abstract

Objectives: The prevalence, clinical features, and outcomes of patients with systemic lupus erythematosus (SLE) complicated with or without aortic aneurysm (AA) were compared in a Chinese single-center cohort.

Methods: Included in this study were SLE patients who received treatment at Shanghai Changhai Hospital between 2000 and 2020. The prevalence, clinical features, and outcomes of these SLE patients with or without AA were compared by Student's t-tests or Fisher's exact tests as appropriate. Risk factors associated with AA occurrence in SLE were evaluated by univariable and multivariable logistic regression analyses. The survival analysis between SLE patients with or without AA was conducted by the Kaplan-Meier method.

Results: Of the 1843 SLE patients included in this study, 16 (0.86%) were identified as having AA, and 160 of the remaining 1825 SLE patients without AA were selected as a simple random sample for comparison. The SLE patients with AA showed a higher proportion of smoking and hypertension as compared with those with no AA. Multivariable logistic regression analysis showed that a long SLE duration and anti-RNP positivity were two independent risk factors associated with AA occurrence in SLE patients. The log rank test showed that SLE patients with AA had a significantly higher risk of progression to death. Renal disorder was associated with an even poorer outcome in SLE patients with AA.

Conclusion: The incidence of AA in SLE patients may be underestimated. The association between AA and SLE, especially in patients with multiple risk factors, should not be ignored. Key Points • The risk of SLE patients developing AA may be higher than that previously estimated. • The risk of SLE patients especially with multiple risk factors developing AA should not be ignored. • The diagnosis of AA should not be forgot when SLE patients present with chest, back, or abdominal symptoms with unexplained causes.

Keywords: Anti-RNP antibody; Aortic aneurysm; Systemic lupus erythematosus (SLE).