Critical peripheral ischemia: Higher prevalence in Indian systemic lupus erythematosus inception cohort for research (INSPIRE).

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2024-08-01 Epub Date: 2024-06-26 DOI:10.1177/09612033241263232
Vineeta Shobha, Liza Rajasekhar, Sandra Manuel, Nayana V, Ranjan Gupta, Saumya Ranjan Tripathy, Parasar Ghosh, Chengappa Kavadichanda, Ashish J Mathew, Manish Rathi, Avinash Jain, Sumitra Selvam, Amita Aggarwal
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引用次数: 0

Abstract

Introduction: There is limited literature on digital ischemia in systemic Lupus erythematosus (SLE). We report the prevalence, associations and outcome of digital infarcts and gangrene from the Indian SLE inception cohort (INSPIRE).

Methods: From the web-based database of INSPIRE, we extracted information for patients with 'Digital Infarct' and 'Digital gangrene' at enrolment into cohort, together considered as critical peripheral ischemia (CPI); all others were controls. We describe the associations of CPI with SLE clinical phenotype, autoantibodies, and disease activity at enrolment. We also report short term outcomes viz. Digital tissue loss and early mortality up to 6 months and recurrence of digital ischemic events in cases till date.

Results: Of 2503 SLE patients enrolled into the INSPIRE cohort, we identified 75 (2.9%) patients with CPI, 72 (96%) women and 6 (8%) children. Of them, 55 (73.3%) had digital gangrene and 21 (28%) patients had digital infarcts. Majority of digital gangrene resulted in amputation distal to terminal phalanx (63.6%). Multivariable analysis showed that pulmonary hypertension AOR [6.34 (1.99, 20.2)], coexistent thrombosis AOR [27.8 (15.7, 48.7)], triple antiphospholipid antibody positivity AOR [5.36 (1.67, 16.9)] and the presence of anti-Scl-70-antibody AOR [5.59 (1.86, 16.7)] were more likely while patients with class 3 or 4 lupus nephritis AOR [0.37 (0.15, 0.95)] and anti-nucleosome antibodies AOR [0.47 (0.23, 0.99)] were less likely to be associated with CPI. SLEDAI and short-term mortality were similar between cases and controls.

Conclusions: CPI occurred in a higher proportion (2.9%) of SLE patients in the INSPIRE cohort as compared to earlier reports. Both prothrombotic state and vasculopathy contribute to its occurrence.

严重外周缺血:印度系统性红斑狼疮初期研究队列(INSPIRE)中的高发病率。
导言:有关系统性红斑狼疮(SLE)中数字缺血的文献十分有限。我们报告了印度系统性红斑狼疮初始队列(INSPIRE)中数字梗塞和坏疽的发病率、关联性和结果:方法:我们从 INSPIRE 的网络数据库中提取了在加入队列时患有 "数字梗塞 "和 "数字坏疽 "的患者的信息,这两种疾病被视为重度外周缺血(CPI);所有其他患者均为对照组。我们描述了CPI与系统性红斑狼疮临床表型、自身抗体和入组时疾病活动性的关系。我们还报告了短期结果,即数字组织缺失、6 个月内的早期死亡率以及迄今为止病例中数字缺血事件的复发情况:在加入INSPIRE队列的2503名系统性红斑狼疮患者中,我们发现了75名(2.9%)CPI患者,其中72名(96%)为女性,6名(8%)为儿童。其中,55人(73.3%)患有数字坏疽,21人(28%)患有数字梗塞。大多数数字坏疽导致末节指骨远端截肢(63.6%)。多变量分析显示,肺动脉高压 AOR [6.34 (1.99, 20.2)]、并存血栓 AOR [27.8 (15.7, 48.7)]、三重抗磷脂抗体阳性 AOR [5.36 (1.67, 16.9)]和存在抗 Scl-70 抗体 AOR [5.59(1.86,16.7)]的可能性更大,而患有 3 级或 4 级狼疮肾炎 AOR [0.37 (0.15,0.95)]和抗核糖体抗体 AOR [0.47 (0.23,0.99)]的患者与 CPI 相关的可能性较小。病例与对照组的SLEDAI和短期死亡率相似:与之前的报告相比,INSPIRE队列中发生CPI的系统性红斑狼疮患者比例更高(2.9%)。促血栓形成状态和血管病变都是导致 CPI 发生的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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