CARACTERIZACIÓN DE LA ENFERMEDAD CARDIOVASCULAR EN PACIENTES CON LUPUS EN EL HOSPITAL DE ESPECIALIDADES TEODORO MALDONADO CARBO DURANTE EL PERIODO 2016 - 2017

Abstract

The lupus erythematosus is an autoimmune disease that affects the connective tissue of the body so the disease can have manifestations of systemic alterations which include: hematological, renal, cutaneous, cutaneous and cardiac muscle, the latter being those that are mostly related to mortality of these patients. The silent nature of cardiac involvement is the reason why it is diagnosed when there is already a severe compromise of the heart and vessels. OBJECTIVE: to determine epidemiological, clinical and imaging characteristics, to identify the most frequent cardiac involvement and traditional and non-traditional cardiovascular risk factors, in addition to its relation to the activity of the disease. METHODS: A descriptive, transversal, retrospective study of the quantitative approach of all lupus patients seen in the outpatient clinic of the "Teodoro Maldonado Carbo" Specialties Hospital during the period 2016 to 2017, from which the data of those patients who already had at least one consult with the cardiology department. RESULTS: Of the 216 lupus patients seen in the study period, the 61 patients who had at least one consult with the cardiology deparment were analyzed. Most of the patients were women between 20 and 40 years. Joint affectation together with pleurisy was the most prevalent general clinical characteristics and chest pain was the most prevalent cardiac clinical manifestation. The pericardial effusion evidenced both in the electrocardiogram (decrease in voltage) and the echocardiogram indicates that pericardial involvement is the most common. For the calculation of cardiac risk, the modified tool Framingham was used. Of the traditional cardiovascular risk factors, BMI greater than 30 kg / m2, cholesterol greater than 200 mg / dL and age above 45 years were the most common; of the non-traditional ones were the use of prednisone, low levels of C3 and high levels of CRP, all of these had a statistically positive relationship with the development of cardiovascular risk, mild or moderate. 57.14% of the patients had a high activity of the disease measured with SLEDAI2K. There was a statistically significant relationship between the value of SLEDAI2K and the mild and severe cardiovascular risk. CONCLUSIONS: Pericardial effusion is the most frequent affectation with a clinical presentation characterized by thoracic pain follow by dyspnea and palpitations. The cardiovascular risk in this population was predominantly moderate. Traditional cardiovascular risk factors such as age cholesterol levels> 200mg / dl, glucose values and non-traditional values that include: Use of prednisone, low levels of C3 and high levels of CRP were associated with an increase in CV risk, as well as High index of disease activity measured with SLEDAI showed a statistically significant relationship in relation to mild and moderate cardiovascular risk (p = 0.018