Abstract 3240: Poor 1-Year Outcomes Following Percutaneous Coronary Interventions (PCI) in Systemic Lupus Erythematosus (SLE): Report from the NHLBI Dynamic Registry
Background: SLE women have premature and accelerated atherosclerosis. Although PCI is often utilized to treat coronary artery disease in SLE, little is known regarding outcomes of intervention immediately post-PCI and after discharge. There also is interest in comparing outcomes of women with SLE to those with diabetes mellitus (DM).
Methods: Baseline demographic, procedure-related and adverse outcome data on consecutive patients (pts) undergoing PCI during 4 recruitment “waves” of the Dynamic Registry across 23 clinical centers in North America were collected. SLE pts (n=20) were compared to nonSLE pts with (n=1434) and without (n=3283) DM.
Results: Compared to both nonSLE groups, pts with SLE were younger, predominantly female and non-white but presented less often with hypertension and hyperlipidemia. SLE pts had less multi-vessel disease and lowest mean number of significant lesions (>/50% stenosis), but were more likely to present with acute coronary syndromes. In-hospital outcomes were similar in all three groups. SLE pts were less likely to be discharged on aspirin than nonSLE pts (70% vs 94% p<0.001). By one year, SLE pts were more likely to require repeat revascularization by PCI or CABG (40%) than nonSLEnonDM (17%, p=0.004) or DM (20%, p=0.02) pts, suffer a MI (22.6% vs 4.5% and 6.8% p<0.01) or a major adverse coronary event (44%) than nonSLEnonDM (22%) pts (p=0.02).
Conclusions: While in-hospital CV outcomes were comparable in SLE and nonSLE pts following PCI, significantly worse CV outcomes were seen at one year in the SLE pts. Despite the small SLE sample, differences in outcome were striking. Further study is warranted to explore factors accounting for this disparity.