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Association of systemic lupus erythematosus with peripheral arterial disease: a meta-analysis of literature studies


Rheumatology (Oxford). 2020 Aug 13;keaa414. doi: 10.1093/rheumatology/keaa414.Online ahead of print.

Francesco Forte 1, Alessio Buonaiuto 1, Ilenia Calcaterra 1, Gabriella Iannuzzo 1, Pasquale Ambrosino 2, Matteo Nicola Dario Di Minno 3

Author Information

1 Department of Clinical Medicine and Surgery, Federico II University, Naples.

2 Istituti Clinici Scientifici Maugeri IRCCS, Pavia.

3 Department of Translational Medical Sciences, Federico II University, Naples, Italy.


Objective: SLE patients have an increased cardiovascular morbidity and mortality. Contrasting data are available about the association between peripheral arterial disease (PAD) and SLE. We aimed to perform a meta-analysis of studies evaluating the association between SLE and PAD.

Methods: Studies were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases according to preferred reporting items for systematic reviews and meta-analyses guidelines.

Results: Eight studies reporting on 263 258 SLE patients and 768 487 controls showed that the prevalence of PAD was 15.8% (95% CI: 10.5%, 23.2%) in SLE patients and 3.9% (95% CI: 1.8%, 7.9%) in controls with a corresponding odds ratio of 4.1 (95% CI: 1.5, 11.6; P <0.001). In addition, five studies reporting on ankle-brachial index showed significantly lower values in 280 SLE patients as compared with 201 controls (mean difference: -0.018; 95% CI: -0.034, -0.001; P =0.033). Meta-regression models showed that age, hypertension and diabetes were inversely associated with the difference in the prevalence of PAD between SLE patients and non-SLE controls, whereas no effect for all the other clinical and demographic variables on the evaluated outcome was found.

Conclusion: SLE patients exhibit an increased prevalence of PAD and lower ankle-brachial index values as compared with non-SLE controls. This should be considered when planning prevention, interventional and rehabilitation strategies for these chronic patients with functional disability and poor long-term outcomes.