Abstract 18653: Long Term Outcomes in Patients With Systemic Lupus Erythematosus Undergoing Cardiac Surgery: A Propensity Analysis

INTRODUCTION The burden of cardiovascular diseases, including coronary artery disease and valvular disease, is greater in patients with systemic lupus erythematosus (SLE) than in the general population. There is a paucity of robust data on short- and long-term outcomes after cardiac surgery in patients with SLE.

AIM To evaluate early (<30 days) and late post-operative morbidity and mortality in patients diagnosed with SLE who underwent valve repair or replacement with or without coronary artery bypass grafting (CABG) compared to non-SLE patients.

METHODS This retrospective propensity matched comparative effectiveness study examined outcomes of patients who underwent valve repair or replacement with or without CABG, from 1/2000-1/2021. Outcomes in non-SLE and SLE surgical population were compared using 2:1 propensity score matching, accounting for baseline patient and procedural characteristics. Primary end points were 30-day and time-related mortality. Additional outcomes included occurrence of stroke, dialysis, blood transfusions, surgical re-exploration, and duration of intensive care unit (ICU) and hospital length of stay.

RESULTS A total of 275,827 patient-years of follow-up information was available; median follow-up for death was 4.3 years. After matching, 265 patients with SLE were compared to 529 without SLE. Both cohorts demonstrated similar in-hospital mortality (2.8% SLE vs. 1.5% Non-SLE, P =.25), one-year survival (90% SLE vs. 89% Non-SLE) and 5-year survival (76% SLE vs. 71% Non-SLE). Length of post-operative ICU stay was shorter in the SLE cohort ( P =.007).

CONCLUSION In patients with SLE selected to undergo cardiovascular surgery, in-hospital, 1 and 5-year morbidity and mortality were similar to the general operative population. A jeopardy for a diagnosis of SLE was not present.