<h3>Background</h3> Cardiovascular diseases represent a major contributor to the increased mortality. Risk factors varies according to the subtypes of cardiovascular events and perhaps racial background. Little is known about the risk of major cardiovascular events (MACE) in Saudi lupus Population. <h3>Objectives</h3> This study aim to examine the prevalence of MACE among Saudi SLE compared to general population and factors associated with such outcome. <h3>Methods</h3> This a cross-sectional study nested within two prospective cohorts to assess the period prevalence of any MACE among SLE patients who were enrolled in national prospective cohort of SLE, Saudi Arabia since its initiation in 2020. As a comparison, Prospective Urban Rural Epidemiology Study Saudi sub-cohort (PURE-Saudi) for participants who have been enrolled during the same follow up period. Participants in both studies were followed using standardized published protocol. MACE was defined as the diagnosis of Myocardial infraction, stroke or Angina. We adjust for demographics, traditional cardiovascular risk factors and the diagnosis of SLE using logistic regression models. <h3>Results</h3> A total of 488 with SLE and 746 from PURE were included. SLE patients were younger (40.7±12.5 compared to 49.5±8.6) and female predominant (90.6% compared to. 41.6%). Prevalence of traditional risk factors were less in SLE patients including dyslipidemia (28.9% compared to 49.4%), obesity (63% compared to 85%) diabetes (7.8% compared to 27.2%) but not HTN (19.3 compared to 18.8%). Odds of MACE were significantly related to Age and Lupus diagnosis (OR: 1.08, 95% CI: 1.04-1.11, p=0.00) and (OR: 7.64, 95% CI: 2.65-22.07, p=0.00) but not CVS risk factors (OR: 0.8, 95% CI: 0.10-6.39, p=0.83). <h3>Conclusion</h3> SLE patients at significant risk of MACE compared to general population. This risk is not well explained by traditional risk factors which may explain the failure of CVS risk scores to adequately stratify SLE patients. Further work is needed to understand the pathogenesis of CVS risk in SLE and subsequently mitigate it. <h3>References</h3> [1]Yurkovich M, Vostretsova K, Chen W, Avina-Zubieta JA. Overall and cause-specific mortality in patients with systemic lupus erythematosus: a meta-analysis of observational studies. Arthritis care & research. 2014;66(4):608-616. [2]Rees F, Doherty M, Grainge MJ, Lanyon P, Davenport G, Zhang W. Mortality in systemic lupus erythematosus in the United Kingdom 1999–2012. Rheumatology. 2016;55(5):854-860. [3]Falasinnu T, Chaichian Y, Li J, et al. Does SLE widen or narrow race/ethnic disparities in the risk of five co-morbid conditions? Evidence from a community-based outpatient care system. Lupus. 2019;28(14):1619-1627. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
