Risk factors of pulmonary arterial hypertension in patients with systemic lupus erythematosus: A meta-analysis

Yuqi Liu; Zhen Cheng; Bowen Zha; Xiaodong Chen; Zhiyu Gong; Lang Ji; Lingling Wei

doi:10.1177/09612033231202398

Risk factors of pulmonary arterial hypertension in patients with systemic lupus erythematosus: A meta-analysis

Lupus. 2023 Oct;32(11):1310-1319. doi: 10.1177/09612033231202398. Epub 2023 Sep 12.

Authors

Yuqi Liu¹, Zhen Cheng², Bowen Zha³, Xiaodong Chen¹, Zhiyu Gong¹, Lang Ji⁴, Lingling Wei⁵

Affiliations

¹ Beijing Luhe Hospital, Capital Medical University, Beijing, China.
² Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
⁴ Central Laboratory, Beijing Luhe Clinical Institute, Capital Medical University, Beijing, China.
⁵ Beijing Key Laboratory of Diabetic Prevention and Research, Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China.

PMID: 37699157
DOI: 10.1177/09612033231202398

Abstract

Objective: To determine the risk factors of pulmonary arterial hypertension (PAH) related to systemic lupus erythematosus (SLE) through systematic reviews and meta-analyses.

Methods: We undertook electronic search strategies using Medline via PubMed, Embase, Web of Science, and Cochrane Library up to April 11, 2023. Study selection and data extraction were performed by 2 authors independently. We made risk of bias judgments based on the Newcastle-Ottawa Scale (NOS). Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to estimate the overall effect sizes of potential risk factors for PAH in SLE patients. Univariate and multivariate meta-regression models were used to assess the independent effects of each risk factor on PAH. Sensitivity analyses were also conducted to explore potential sources of heterogeneity.

Results: A total of 19 articles were included in this meta-analysis, and the results showed that gender (female) [RR = 1.04, 95% CI (1.02, 1.06), p = .0001], interstitial lung disease [RR = 4.36, 95% CI (2.42, 7.85), p = .0001], alopecia [RR = 1.39, 95% CI (1.06, 1.83), p = .017], Raynaud's phenomenon [RR = 1.83, 95% CI (1.41, 2.37), p = .0001], systemic hypertension [RR = 1.30, 95% CI (1.07, 1.58), p = .007], serositis [RR = 2.29, 95% CI (1.89, 2.77), p = .0001], pericardial effusion [RR = 3.33, 95% CI (2.20, 5.05), p = .0001], anti-RNP [RR = 1.86, 95% CI (1.19, 2.91), p = .006], anti-SSA [RR = 1.28, 95% CI (1.01, 1.62), p = .041], anti-SSB [RR = 1.38, 95% CI (1.19, 1.60), p = .0001], anti-U1RNP [RR = 1.58, 95% CI (1.07, 2.34), p = .023], thrombocytopenia [RR = 1.38, 95% CI (1.14, 1.68), p = .001], and current smokers [RR = 2.20, 95% CI (1.19, 4.06), p = .012] were all risk factors for PAH related to SLE.

Conclusion: PAH is a serious complication of SLE. Since prognosis of SLE patients after the occurrence of PAH is poor, routine examination should be conducted for SLE patients with PAH risk factors.

Keywords: Pulmonary arterial hypertension; meta-analysis; risk factors; systemic lupus erythematosus.

Publication types

Meta-Analysis

MeSH terms

Female
Humans
Hypertension, Pulmonary* / diagnosis
Hypertension, Pulmonary* / epidemiology
Hypertension, Pulmonary* / etiology
Lupus Erythematosus, Systemic* / complications
Lupus Erythematosus, Systemic* / diagnosis
Lupus Erythematosus, Systemic* / epidemiology
Prognosis
Pulmonary Arterial Hypertension* / epidemiology
Pulmonary Arterial Hypertension* / etiology
Risk Factors