Association between SLICC/ACR damage index and outcomes for lupus patients after cardiac valve surgery. (23rd August 2022)

• Record Type: Journal Article
• Authors: Hu, Szu-Yen; Cheng, Chiao-Feng; Yang, Kelvin Jeason; Wang, Chih-Hsien; Chi, Nai-Hsin; Hsu, Ron-Bin; Chen, Yih-Sharng; Yu, Hsi-Yu
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 35:Number 4(2022)
• Publication Date: 2022-08-23
• Subjects: Systemic lupus erythematosus -- Cardiac valves -- Cardiac valve prostheses -- Follow-up study; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivac221
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: Systemic lupus erythematosus (SLE) is associated with multi-organ damage including cardiac valve, which may need valvular operation. However, methods for outcome prediction and prosthetic valve selection are unclear in SLE patients undergoing cardiac valve surgery. Twenty-five SLE patients receiving valvular operation in a single institute between 2002 and 2020 were enrolled. Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR damage index, SDI) was applied to evaluate the damage severity. Clinical outcomes were compared between patients with different SDI. The hospital survival rate was 88%, and long-term survival rate was 59.5% and 40.2% at 5 and 10 years. The median SDI was 4 (interquartile range 3–6) in our study, patients were then grouped into higher SDI (defined as SDI ≥ 5, n = 11) and lower SDI group (defined as SDI < 5, n = 14). The in-hospital survival rate (72.2% vs 100%, P = 0.074) and 5-year survival rate (18.2% vs 92.9%, P < 0.001) were lower in higher SDI group, compared to lower SDI group. SDI score was associated with long-term outcome for SLE patients receiving cardiac valve surgery. SDI ≥ 5 was associated with very poor long-term outcomes. This finding implicates that xenograft might be a reasonable choice for SLE patients with SDI ≥ 5. Abstract : Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple organ involvement.