Clonal Hematopoiesis of Indeterminate Potential and Accelerated Atherosclerosis in Patients With Systemic Lupus Erythematosus
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Systemic Lupus Erythematosus
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 500
- Locations
- 1
- Primary Endpoint
- The primary outcome was the occurrence of cardiovascular events (CVE) over follow-up.
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
Accelerated atherosclerosis in patients with systemic lupus erythematosus (SLE) is not fully explained by Framingham risk factors. The detection in asymptomatic patients of somatic mutations in genes involved in hematopoietic malignancy- defining clonal hematopoiesis of indeterminate potential (CHIP) - predisposes to cardiovascular events (CVE) in general population. We aimed to determine whether CHIP is associated with CVE in SLE.
Detailed Description
SLE patients indeed display an accelerated atherosclerosis that strongly contributes to the excess mortality observed but is poorly explained by the traditional cardiovascular risk factors. Clonal hematopoiesis defines the clonal expansion of hematopoietic cells driven by a selective advantage given by leukemia-associated somatic mutations. Clonal hematopoiesis is said of indeterminate potential (CHIP) when found in asymptomatic patient. CHIP strongly correlated with age and logically predispose to haematological malignancy, but is also causally associated with cardiovascular events (CVE) in the general population. The main objective of our study was to determine whether CHIP is associated with CVE in SLE patients.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patient with a systemic lupus erythematosus
Exclusion Criteria
- •Inadequate follow-up period (\< 20 months) -past history of CVE at baseline for inclusion in the TROPOPLUS study
Outcomes
Primary Outcomes
The primary outcome was the occurrence of cardiovascular events (CVE) over follow-up.
Time Frame: >20 months after PLUS inclusion
Incidents CVE were ascertained by physician interview using a standardized questionnaire and through examination of medical records. CVE included coronary heart disease, stroke, revascularization procedure for other atherosclerotic cardiovascular diseases and sudden cardiac death. Coronary heart disease was defined as a history of angina, coronary revascularization, or myocardial infarction. All CVE that occurred through March 2019 were considered for analysis
Secondary Outcomes
- Prevalence of CHIP in SLE(at PLUS inclusion)