Evidence map›Paper›PMID 32445088›Full record

ArticleClinical rheumatology2020

Acute myocardial dysfunction in lupus: outcomes in Asian Indians.

Aadhaar Dhooria, Atit Gawalkar, Krishna Santosh, Ajay Bahl, Adarsh Mb, Gsrsnk Naidu, Shefali Sharma, Aman Sharma, Sanjay Jain, Varun Dhir

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Article in Clinical rheumatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Aadhaar DhooriaDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Atit GawalkarDepartment of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Krishna SantoshDepartment of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Ajay BahlDepartment of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Adarsh MbDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Gsrsnk NaiduDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Shefali SharmaDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Aman SharmaDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Sanjay JainDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Varun DhirDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India. varundhir@gmail.com.ORCID http://orcid.org/0000-0002-3626-0694
Post Graduate Institute of Medical Education and Research · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute myocardial dysfunction is an uncommon but potentially fatal complication in systemic lupus erythematosus (SLE). We describe the outcome in a small series of Asian Indian patients and examine associated factors.

methodsSLE patients who fulfilled the 2012 SLICC criteria and developed new-onset myocardial dysfunction were included in this retrospective case series. Acute myocardial dysfunction was defined as global hypokinesia and left ventricular ejection fraction (LVEF)<50% on echocardiography (with or without symptoms) in patients with SLE. Survival was assessed using Kaplan-Meier survival analysis and Cox regression.

resultsThis study included 37 patients with mean age 28.2 ± 11.2 years and median (range) LVEF of 35% (18-48%) at presentation. A majority had active disease, with SLEDAI-2k ≥ 5 in 26 (of 28). All patients received oral corticosteroids and a majority received additional immunosuppression, including pulse methylprednisolone in 28 and cyclophosphamide in 27. Nine patients died during hospitalisation (25%), a majority due to infections. Death was significantly associated with elevated procalcitonin at presentation (p = 0.05), elevated white cell count (p = 0.02) and low complement C3 (p = 0.03). In those who survived, long-term outcomes were good, with complete myocardial recovery in 14 (64%). A higher ejection fraction at presentation was associated with complete recovery.

conclusionsIn this small series of patients of SLE with acute myocardial dysfunction, we report a significant in-hospital mortality due to infections. Many of the patients who died had elevated procalcitonin at presentation. A diligent search for infection seems prudent in lupus patients who present with acute myocardial dysfunction. Key Points • In patients of SLE with acute myocardial dysfunction who were treated with immunosuppression, there was significant short-term mortality due to infections. • This mortality was associated with elevated procalcitonin at baseline and may suggest some of them had pre-existing hidden sepsis. • A prudent search for infections in these patients before immunosuppression may help to decrease short-term mortality.

Indexed as

Lupus Erythematosus, SystemicAdolescentAdultCyclophosphamideHumansRetrospective StudiesStroke VolumeVentricular Function, LeftYoung AdultCyclophosphamideMyocardial dysfunctionMyocardial recoverySLESurvival

Identifiers

PMID32445088
OpenAlexW3028346317

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.