Relationship between damage clustering and mortality in systemic lupus erythematosus in early and late stages of the disease: cluster analyses in a large cohort from the Spanish Society of Rheumatology Lupus Registry
Por:
Pego-Reigosa, JM, Lois-Iglesias, A, Rua-Figueroa, I, Galindo, M, Calvo-Alen, J, de Una-Alvarez, J, Balboa-Barreiro, V, Ruan, JI, Olive, A, Rodriguez-Gomez, M, Nebro, AF, Andres, M, Erausquin, C, Tomero, E, Rubio, LH, Isacelayam, EU, Freire, M, Montilla, C, Sanchez-Atrio, AI, Santos-Soler, G, Zea, A, Diez, E, Narvaez, J, Blanco-Alonso, R, Silva-Fernandez, L, Ruiz-Lucea, ME, Fernandez-Castro, M, Hernandez-Beriain, JA, Gantes-Mora, M, Hernandez-Cruz, B, Perez-Venegas, J, Pecondon-Espanol, A, Fernandez-Cid, CM, Ibanez-Barcelo, M, Bonilla, G, Torrente-Segarra, V, Castellvi, I, Alegre, JJ, Calvet, J, de la Fuente, JLM, Raya, E, Vazquez-Rodriguez, TR, Quevedo-Vila, V, Munoz-Fernandez, S, Oton, T, Rahman, A, Lopez-Longo, FJ
Publicada:
1 jul 2016
Resumen:
Objectives. To identify patterns (clusters) of damage manifestations within a large cohort of SLE patients and evaluate the potential association of these clusters with a higher risk of mortality.
Methods. This is a multicentre, descriptive, cross-sectional study of a cohort of 3656 SLE patients from the Spanish Society of Rheumatology Lupus Registry. Organ damage was ascertained using the Systemic Lupus International Collaborating Clinics Damage Index. Using cluster analysis, groups of patients with similar patterns of damage manifestations were identified. Then, overall clusters were compared as well as the subgroup of patients within every cluster with disease duration shorter than 5 years.
Results. Three damage clusters were identified. Cluster (80.6% of patients) presented a lower amount of individuals with damage (23.2 vs 10096 in clusters 2 and 3. P < 0.001). Cluster 2 (11.4% of patients) was characterized by musculoskeletal damage in all patients. Cluster 3 0.096 of patients) was the only group with cardiovascular damage, and this was present in all patients. The overall mortality rate of patients in clusters 2 and 3 was higher than that in cluster 1 (P < 0.001 for both comparisons) and in patients with disease duration shorter than 5 years as well.
Conclusion. In a large cohort of SLE patients, cardiovascular and musculoskeletal damage manifestations were the two dominant forms of damage to sort patients into clinically meaningful clusters. Both in early and late stages of the disease, there was a significant association of these clusters with an increased risk of mortality. Physicians should pay special attention to the early prevention of damage in these two systems.
Filiaciones:
Pego-Reigosa, JM:
Univ Hosp Complex Vigo, Dept Rheumatol, Vigo, Spain
Inst Invest Biomed Vigo, IRIDIS Grp, Vigo, Spain
Lois-Iglesias, A:
Univ A Coruna, Med & Rheumatol Dept, La Coruna, Spain
Rua-Figueroa, I:
Hosp G Canaria Doctor Negrin, Rheumatol Dept, Las Palmas Gran Canaria, Spain
Galindo, M:
Hosp Univ 12 Octubre, Dept Rheumatol, Madrid, Spain
Calvo-Alen, J:
Hosp Sierrallana, Dept Rheumatol, Cantabria, Spain
de Una-Alvarez, J:
Univ Vigo, Dept Stat & OR, Vigo, Spain
Balboa-Barreiro, V:
Univ Vigo, Dept Stat & OR, Vigo, Spain
Ruan, JI:
Hosp Povisa, Dept Rheumatol, Vigo, Spain
Olive, A:
Hosp Badalona Germans Trias & Pujol, Rheumatol Dept Badalona, Barcelona, Spain
Rodriguez-Gomez, M:
Complejo Hospitalario Ourense, Rheumatol Dept Ourense, Orense, Spain
Hosp Univ Principe Asturias, Dept Rheumatol, Madrid, Spain
Nebro, AF:
Hosp Carlos Haya, Dept Rheumatol, Malaga, Spain
Univ Malaga, Dept Med, Malaga, Spain
Andres, M:
Alicante Univ Hosp, Dept Rheumatol, Alicante, Spain
Erausquin, C:
Hosp G Canaria Doctor Negrin, Rheumatol Dept, Las Palmas Gran Canaria, Spain
Tomero, E:
Hosp Univ Princesa, Dept Rheumatol, Madrid, Spain
Rubio, LH:
Hosp Navarra, Dept Rheumatol, Pamplona, Spain
Isacelayam, EU:
Donostia Univ Hosp, Dept Rheumatol, San Sebastian, Spain
Freire, M:
Hosp Juan Canalejo, Rheurnatol Dept, La Coruna, Spain
Montilla, C:
Hosp Clin Salamanca, Dept Rheumatol, Salamanca, Spain
Santos-Soler, G:
Hosp Marina Baixa, Dept Rheumatol, Alicante, Spain
Zea, A:
Hosp Univ Raman & Cajal, Dept Rheumatol, Madrid, Spain
Diez, E:
Complejo Asistencial Univ Leon, Dept Rheumatol, Leon, Spain
Narvaez, J:
Hosp Univ Bellvitge, Dept Rheumatol, Barcelona, Spain
Blanco-Alonso, R:
Hosp Univ Marques de Valdecilla, Dept Rheumatol, Santander, Spain
Silva-Fernandez, L:
Hosp Univ Guadalajara, Dept Rheumatol, Guadalajara, Spain
Ruiz-Lucea, ME:
Hosp Basurto, Dept Rheumatol, Bilbao, Spain
Fernandez-Castro, M:
Hosp Univ Puerta de Hierro Majadahonda, Dept Rheumatol, Madrid, Spain
Hernandez-Beriain, JA:
Hosp Insular Gran Canaria, Dept Rheumatol, Las Palmas Gran Canaria, Spain
Gantes-Mora, M:
Hosp Univ Canarias, Dept Rheumatol, Tenerife, Spain
Hernandez-Cruz, B:
Hosp Virgen Macarena, Dept Rheumatol, Seville, Spain
Perez-Venegas, J:
Hosp Jerez, Dept Rheumatol, Cadiz, Spain
Pecondon-Espanol, A:
Hosp Miguel Servet, Dept Rheumatol, Zaragoza, Spain
Fernandez-Cid, CM:
Hosp Virgen Arrixaca, Dept Rheumatol, Murcia, Spain
Ibanez-Barcelo, M:
Hosp Son Llatzer, Dept Rheumatol, Palma de Mallorca, Spain
Bonilla, G:
La Paz Univ Hosp, Dept Rheumatol, Madrid, Spain
Torrente-Segarra, V:
Hosp Moises Broggi Hosp Hosp Hosp, Rheumatol Dept, Barcelona, Spain
Castellvi, I:
Hosp Univ Santa Creu & St Pau, Rheumatol Dept, Barcelona, Spain
Alegre, JJ:
Hosp Univ Doctor Peset, Dept Rheumatol, Valencia, Spain
Calvet, J:
Hosp Univ Parc Tauli, Dept Rheumatol, Barcelona, Spain
de la Fuente, JLM:
Valme Univ Hosp, Dept Rheumatol, Seville, Spain
Raya, E:
Hosp Clin San Cecilia, Rheumatol Dept, Granada, Spain
Vazquez-Rodriguez, TR:
Hosp Lucus Augusti, Dept Rheumatol, Lugo, Spain
Quevedo-Vila, V:
Hosp Monforte, Dept Rheumatol, Lugo, Spain
Munoz-Fernandez, S:
Hosp Infanta Sofia, Dept Rheumatol, Madrid, Spain
Oton, T:
Hosp Torrejon de Ardoz, Dept Rheumatol, Madrid, Spain
Rahman, A:
Univ Coll London Hosp, Dept Rheumatol, London, England
Lopez-Longo, FJ:
Hosp Gen Univ Gregorio Maranon, Dept Rheumatol, Madrid, Spain
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