PMID- 37285617
OWN - NLM
STAT- MEDLINE
DCOM- 20230717
LR  - 20230718
IS  - 2352-3964 (Electronic)
IS  - 2352-3964 (Linking)
VI  - 93
DP  - 2023 Jul
TI  - Cutaneous lupus erythematosus is associated with an increased risk of cardiac and 
      vascular diseases: a large-scale, propensity-matched global retrospective cohort 
      study.
PG  - 104639
LID - S2352-3964(23)00204-9 [pii]
LID - 10.1016/j.ebiom.2023.104639 [doi]
LID - 104639
AB  - BACKGROUND: Autoimmune skin diseases can expedite various systemic sequelae 
      involving other organs. Although limited to the skin, cutaneous lupus 
      erythematosus (CLE) was noted to be associated with thromboembolic diseases. 
      However, small cohort sizes, partially discrepant outcomes, missing data on CLE 
      subtypes, and incomplete risk assessment limits these findings. METHODS: The 
      Global Collaborative Network of TriNetX provides access to medical records of 
      more than 120 million patients worldwide. We used TriNetX to elucidate the risk 
      for cardiac and vascular diseases after diagnosis of CLE, and its subtypes 
      chronic discoid (DLE) and subacute cutaneous lupus erythematosus (SCLE). We 
      included 30,315 CLE, 27,427 DLE, and 1613 SCLE patients. We performed 
      propensity-matched cohort studies determining the risk to develop cardiac and 
      vascular diseases (ICD10CM:I00-99) following diagnosis of CLE, DLE, or SCLE. 
      Patients with systemic lupus erythematosus were excluded. FINDINGS: We document 
      that CLE and its subtype DLE but less so SCLE are associated with a higher risk 
      for various cardiac and vascular diseases. This included predominantly 
      thromboembolic events such as pulmonary embolism, cerebral infarction, and acute 
      myocardial infarction, but also peripheral vascular disease and pericarditis. For 
      example, the hazard ratio of arterial embolism and thrombosis was 1.399 
      (confidence interval: 1.230-1.591, p < 0.0001) following CLE diagnosis. The study 
      is limited by retrospective data collection and reliance on ICD10-disease 
      classification. INTERPRETATION: CLE and its major subtype DLE are associated with 
      an increased risk for the development of a wide range of cardiac and vascular 
      diseases. FUNDING: This research was funded by Deutsche Forschungsgemeinschaft 
      (EXC 2167, CSSL/CS01-2022) and the Excellence-Chair Program of the State of 
      Schleswig-Holstein.
CI  - Copyright (c) 2023 The Author(s). Published by Elsevier B.V. All rights reserved.
FAU - Olbrich, Henning
AU  - Olbrich H
AD  - Department of Dermatology, University of Lubeck, Lubeck, Germany. Electronic 
      address: henning.olbrich@uksh.de.
FAU - Kridin, Khalaf
AU  - Kridin K
AD  - Lubeck Institute of Experimental Dermatology, University of Lubeck, Lubeck, 
      Germany; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; Unit of 
      Dermatology and Skin Research Laboratory, Barch Padeh Medical Center, Poriya, 
      Israel.
FAU - Zirpel, Henner
AU  - Zirpel H
AD  - Comprehensive Center for Inflammation Medicine, University-Hospital 
      Schleswig-Holstein, Lubeck, Germany.
FAU - Sadik, Christian D
AU  - Sadik CD
AD  - Department of Dermatology, University of Lubeck, Lubeck, Germany.
FAU - Terheyden, Patrick
AU  - Terheyden P
AD  - Department of Dermatology, University of Lubeck, Lubeck, Germany.
FAU - Thaci, Diamant
AU  - Thaci D
AD  - Comprehensive Center for Inflammation Medicine, University-Hospital 
      Schleswig-Holstein, Lubeck, Germany.
FAU - Ludwig, Ralf J
AU  - Ludwig RJ
AD  - Department of Dermatology, University of Lubeck, Lubeck, Germany; Lubeck 
      Institute of Experimental Dermatology, University of Lubeck, Lubeck, Germany.
FAU - Boch, Katharina
AU  - Boch K
AD  - Department of Dermatology, University of Lubeck, Lubeck, Germany.
LA  - eng
PT  - Journal Article
DEP - 20230606
PL  - Netherlands
TA  - EBioMedicine
JT  - EBioMedicine
JID - 101647039
SB  - IM
MH  - Humans
MH  - *Lupus Erythematosus, Discoid/complications/diagnosis
MH  - Retrospective Studies
MH  - *Lupus Erythematosus, Cutaneous/epidemiology/complications/diagnosis
MH  - *Lupus Erythematosus, Systemic/complications/epidemiology
MH  - *Vascular Diseases/epidemiology/etiology
MH  - Cohort Studies
PMC - PMC10279782
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - Cutaneous lupus
OT  - Lupus
OT  - Myocardial infarction
OT  - Pulmonary embolism
OT  - Stroke
COIS- Declaration of interests The authors declare that this study was designed and 
      conducted in the absence of any financial or commercial relationships that could 
      be construed as a potential conflict of interest.
EDAT- 2023/06/07 19:42
MHDA- 2023/07/17 06:42
PMCR- 2023/06/06
CRDT- 2023/06/07 18:00
PHST- 2023/01/12 00:00 [received]
PHST- 2023/05/15 00:00 [revised]
PHST- 2023/05/18 00:00 [accepted]
PHST- 2023/07/17 06:42 [medline]
PHST- 2023/06/07 19:42 [pubmed]
PHST- 2023/06/07 18:00 [entrez]
PHST- 2023/06/06 00:00 [pmc-release]
AID - S2352-3964(23)00204-9 [pii]
AID - 104639 [pii]
AID - 10.1016/j.ebiom.2023.104639 [doi]
PST - ppublish
SO  - EBioMedicine. 2023 Jul;93:104639. doi: 10.1016/j.ebiom.2023.104639. Epub 2023 Jun 
      6.