Cardiac Complications in Systemic Lupus Erythematosus: A Systematic Review of Diagnostic and Prognostic Gaps
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystem involvement and fluctuating activity. Among its many complications, cardiovascular disease (CVD) is a leading cause of morbidity and mortality, with up to 25% of patients affected. Cardiac manifestations, such as pericarditis, myocarditis, and accelerated atherosclerosis, are often underdiagnosed due to their subclinical presentation and lack of standardized screening protocols. This systematic review aims to synthesize current evidence on the incidence, detection, and prognostic challenges of cardiac complications in SLE patients and to identify gaps in current risk stratification and diagnostic methods. A comprehensive literature search was conducted across Ovid, CINAHL, EMBASE, and Web of Science using predefined search terms related to SLE, cardiovascular complications, disease flares, and diagnostic tools (e.g., biomarkers, cardiac MRI). English-language studies published between 2015 and 2025 involving adults (≥18 years) were included. Eligible studies focused on cardiac complications in SLE patients and reported outcomes such as incidence, diagnostic markers, or evidence of underdiagnosis. Exclusion criteria included pediatric populations, non-SLE autoimmune diseases, lack of cardiac outcome data, animal/in vitro studies, non-English papers, reviews, and editorials. Across 31 studies encompassing over 7,000 patients with SLE, cardiac symptoms were frequent, ranging from subclinical…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 7,000 participants or records.
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