THU0336 Predictors of subclinical carotid atheromatosis in patients with systemic lupus erythematosus: relevance of activity, damage and severity indexes

J.C. Quevedo, H. Sánchez, I. Rua-Figueroa, B. Tejera, A. de Vera, A. González-Delgado, C. Rodríguez-Lozano, I. Ferraz-Amaro
2018 THURSDAY, 14 JUNE 2018   unpublished
months of SLE onset were evaluated with yearly visits to update co-morbidities, pregnancy status, and medications. Study visits with a current pregnancy were assessed for aspirin use and preeclampsia risk factors. Aspirin use was compared over time and among those with and without traditional risk factors for preeclampsia (i.e. hypertension, renal disease, diabetes, nulliparity, BMI!35, age >40), as well as known disease-specific risk factors (i.e. antiphospholipid antibodies [+aPL],
more » ... [+aPL], nephritis). Results: We identified 297 women who had 479 pregnancies over the study period. Mean age during pregnancy was 31 (SD 4.9) years and 30% were nulliparous. Half of the pregnancies experienced !1 traditional preeclampsia risk factors in addition to SLE, while a third had +aPL. We observed aspirin use in 121/475 25% of pregnancies (95% CI 22,29) versus 22% (95%CI 19,25) of visits before and after pregnancy among the same women. Aspirin use was similar among pregnancies with and without !1 traditional risk factor for preeclampsia [25% (95%CI 20,31) versus 26% (95%CI 21,32)], while we observed a higher prevalence of aspirin use in those with +aPL (38%, 95% CI 24,55) versus those without (23%, 95% CI 15,34). There was a significant difference in aspirin use based on maternal race/ethnicity, with 67/205 (33%, 95% CI 26,39) aspirin use in Caucasians versus 9/88 (10%, 95% CI 5,18) for black women. Prevalence of aspirin use in pregnancy varied across regions (12%>37%), and did not increase over time. Abstract THU0334 -Table 1. Prevalence of preeclampsia (PE) risk factors among pregnant SLE visits and prevalence of ASA use among women with and without PE risk factors Risk factor Overall prevalence n=475 n (%) Prevalence of ASA use (%, 95% CI) With risk factor Without risk factor Age>40 14 (3) 2/14 (14%, 4-40) 119/461 (26%, 22-30) BMI!35 33/437 8 8/33 (24%, 13-41) 113/404 (28%, 24-33) Nulliparous 136/461 30 37/136 (27%, 20-35) 80/325 (25%, 20-30) Renal disease 83 (17) 17/83 (20%, 13-30) 104/392 (27%, 22-31) Nephritis 53 (11) 11/53 (21%, 12-23) 109/422 (26%, 22-30) Hypertension 79 (17) 24/79 (30%, 21-41) 97/396 (24%, 21-29) Diabetes 2 (0) 0/2 (0%, 0-1) 121/473 (26%, 22-30) !1 traditional PE risk factor 234 (49) 58/234 (25%, 20-31) 63/241 (26%, 21-32) aPL + 34/104 33 13/34 (38%, 24-55) 16/70 (23%, 15-34) Conclusions: In this cohort including 479 SLE pregnancies, most pregnant women were not on aspirin and half had preeclampsia risk factors in addition to SLE. It is possible that aspirin was introduced at/or following the study visit when the pregnancy was documented, highlighting the importance of the treating rheumatologist in reviewing aspirin use and initiating it in pregnant SLE women. Our findings suggest black SLE women as a potentially vulnerable group during pregnancy, having the lowest prevalence of aspirin use.
doi:10.1136/annrheumdis-2018-eular.5749 fatcat:uq72ql7yi5fkjmoiacd3nhjqru