Clinical and demographic characteristics, cardiovascular profile and therapeutic strategy in patients with systemic lupus erythematosus

Objective: To assess the clinical and demographic features, the structure of organ and cardiovascular involvement, as well as the nature of therapy and disease activity dynamics in patients with systemic lupus erythematosus (SLE) at the hospital stage. Materials and Methods: A retrospective analysis of 137 case histories of patients with systemic lupus erythematosus (SLE) was conducted. They were hospitalized in the rheumatology departments of the Shifobakhsh National Medical Center of the Republic of Tajikistan (Dushanbe) and the Sughd Regional Clinical Hospital named after S. Kutfidinov (Khujand) between 2021 and 2024. The diagnosis was verified according to the current classification criteria of ACR 1997, SLICC 2012, and/or EULAR/ACR 2019. Results: The majority of patients were women of reproductive age (90.5%, median age 36.7 years), with a female-to-male ratio of 9.5:1. Most patients had multiple organ involvement at presentation: 59.1% were diagnosed with lupus nephritis, and 68.6% had hematological disorders. The prevalence of arterial hypertension and dyslipidemia reached 56.9% and 36.5%, respectively, and 6.6% had already suffered a stroke or myocardial infarction. Factors associated with cardiovascular complications in systemic lupus erythematosus were identified: older age, disease duration greater than 5 years, lupus nephritis, antiphospholipid antibodies, persistent lupus activity (SLEDAI >= 6), overweight, and dyslipidemia. Despite a decrease in the median SLEDAI-2K score from 14 to 7 points during hospital therapy, only 33.6% of patients achieved the target (SLEDAI <= 5). Conclusion: Systemic lupus erythematosus (SLE) in hospitalized patients presents with a high incidence of multiorgan damage and significant cardiovascular and comorbid burden. The identified clinical and metabolic factors indicate the need for early risk assessment and more aggressive cardioprotective strategies.