Background : Autoimmune diseases, including systemic lupus erythematosus, have been associated with a substantial risk of cardiovascular morbidity and mortality. However, data on the long-term risk of incident heart failure and other adverse cardiovascular outcomes among patients diagnosed with cutaneous lupus erythematosus (CLE) are limited. Methods: In this cohort study, all patients ≥ 18 years with newly diagnosed CLE between 1996 and 2018 were identified through Danish nationwide registries and matched 1:4 by age, sex, and comorbidity with individuals without CLE. Incident adverse cardiovascular outcomes, including heart failure, were compared between the matched groups, overall, and according to sex. Results: Of 2085 patients diagnosed with CLE, 2062 patients were matched with 8248 control subjects from the Danish background population (median age 50 years [25th–75th percentile: 37–62 years]; 22.3% men). The median follow-up was 6.2 years. The 10-year cumulative incidences and adjusted hazard ratios (HR) of outcomes were as follows: heart failure: 3.29% (95% CI, 2.42–4.36%) for CLE patients versus 2.59% (2.20–3.02%) for the background population, HR 1.67 (95% CI, 1.24–2.24); atrial fibrillation or flutter: 5.15% (3.99–6.52%) versus 3.84% (3.37–4.36%), HR 1.40 (1.09–1.80); the composite of ICD implantation, ventricular arrhythmia, or cardiac arrest: 0.72% (0.34–1.40%) versus 0.44% (0.29–0.64%), HR 1.71 (0.85–3.45); the composite of pacemaker implantation, atrioventricular block, or sinoatrial dysfunction: 0.91% (0.48–1.59%) versus 0.54% (0.37–0.76%), HR 1.32 (0.72–2.41); myocardial infarction: 3.05% (2.18–4.15%) versus 1.59% (1.29–1.93%), HR 2.15 (1.53–3.00); ischemic stroke: 3.25% (2.38–4.32%) versus 2.50% (2.13–2.93%), HR 1.56 (1.16–2.10); and venous thromboembolism: 2.74% (1.94–3.75%) versus 2.05% (1.71–2.44%), HR 1.60 (1.16–2.21). Sex did not modify the association between CLE and adverse cardiovascular outcomes (Pinteraction ≥ 0.12 for all outcomes). Conclusions: Patients with CLE had a higher associated risk of adverse cardiovascular outcomes compared with the background population, irrespective of sex. Key Points • Findings: In this nationwide cohort study, including 2062 patients with cutaneous lupus erythematosus and 8248 matched controls, cutaneous lupus erythematosus was associated with an increased long-term risk of heart failure, cardiac arrhythmias, and thromboembolic events, irrespective of sex. [ABSTRACT FROM AUTHOR]