Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


Racial Disparities in Age of CVD in SLE

Scalzi,  Lisabeth V., Hollenbeak,  Christopher S., Wang,  Li

Purpose:

To identify if inter-racial age differences exist for cardiovascular (CVD) events and CVD mortality in systemic lupus erythematosus (SLE) patients.

Methods:

Using data from the Health Care Utilization Project (HCUP) for 2003–2005, 17.6 million hospital admissions were analyzed to examine racial disparities of mean ages for in-hospital CVD events and CVD mortality in SLE patients vs non-SLE patients. HCUP is a sample of nearly 1,000 hospitals from 37 states. SLE and CVD were identified by the ICD-9 code from hospital discharge diagnoses. Mean ages for Non-SLE and SLE patients in each racial group were computed and used to calculate the difference between SLE and non-SLE (Age D Non SLE vs SLE) and the diference between White SLE patients and each minority SLE group (Age D White SLE vs minority).

Results:

There were 11,099 admissions identified for CVD and 1,746 CVD mortalities in SLE. The mean ages and racial breakdown for SLE CVD events was; White, 64.5 years (yrs) (66%), Black 53.2 yrs (22%), Hispanic 55.4 yrs (8.4%), Asian 56.5 yrs (1.6%), and Other 58.1 yrs (2.1%). The mean ages and racial breakdown for in-hospital SLE CVD mortality was; White 67.4 yrs (69.8%), Black 55.5 yrs (18.9%), Hispanic 61.7 yrs (6.3%), Asian 62.7 yrs (3.4%), and Other 65.8 yrs (1.6%). SLE patients were all younger than non-SLE patients and White SLE patients were older than all minority groups for both outcomes.

The greatest age difference between SLE and non-SLE patients with CVD was in the Asian group (14.3 yrs), followed by a 13 yrs for Hispanics, 12.4 yrs for Blacks, 9.6 yrs for Others, and a 7.5 yrs for Whites (See Table 1). This changed when examining age differences for CVD mortality. Black SLE patients were 16.7 yrs younger, Asian SLE patients 14.1 yrs, Hispanics 12.8 yrs, Whites 11 yrs, and the Other group was 9.2 yrs younger than the race-matched non-SLE groups for CVD mortality.

Table 1. Mean Age Differences in SLE with CVD and CVD Mortality

 WhitesBlacksHispanicsAsiansOther
CVD     
Number of SLE Patients7,3402,407936181235
Age D Non SLE vs SLE (yrs)7.512.41314.39.6
Age D White SLE vs minority (yrs) 11.39.18.06.4
CVD Mortality     
Number of SLE Patients10044711714753
Age D Non SLE vs SLE (yrs)1116.712.814.19.2
Age D White SLE vs minority (yrs) 14.812.111.613.7

We also examined the age differences between White patients and minority populations (See Table 1). The greatest age difference between White SLE patients and any of the minority groups was with the Black SLE patients. There was 11.7 year difference between Whites and Blacks with CVD admissions, and a 14.8 year difference for CVD mortality.

Conclusion:

Age at CVD admission and CVD mortality differs between racial groups in SLE patients. The greatest age difference between SLE and non-SLE patients for CVD admission was in the Asian group (14.3 years younger than Asians without SLE) and was in the Black group for CVD mortality (16.7 years younger than Blacks without SLE). The greatest age difference between White SLE patients and a minority group was with Black patients. In the SLE population, Black patients were 11.3 years younger than Whites with CVD admissions and 14.8 years younger with CVD mortality. More detailed data analysis is warranted to examine if identifiable group characteristics may be related to these racial disparities.

To cite this abstract, please use the following information:
Scalzi, Lisabeth V., Hollenbeak, Christopher S., Wang, Li; Racial Disparities in Age of CVD in SLE [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1552
DOI: 10.1002/art.26626

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