Prevalence of coronary heart disease and cardiovascular risk factors in a national cross-sectional cohort study of systemic sclerosis
- Gene-Siew Ngian1,
- Joanne Sahhar2,
- Susanna M Proudman3,
- Wendy Stevens4,
- Ian P Wicks1,
- Sharon Van Doornum1
- 1Department of Medicine (RMH/WH), The University of Melbourne, Victoria, Australia
- 2Rheumatology Unit, Monash Medical Centre, Melbourne, Australia
- 3The University of Adelaide and Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia
- 4Rheumatology Unit, St Vincent's Hospital, Melbourne, Australia
- Correspondence to Gene-Siew Ngian, Department of Medicine (RMH/WH)The University of Melbourne, Grattan StParkville 3050, Victoria, Australia;
- Accepted 25 March 2012
- Published Online First 24 April 2012
Objectives To determine the prevalence of coronary heart disease (CHD) and cardiovascular risk factors in a well-characterised cohort of systemic sclerosis (SSc) patients, and to compare this with the general population.
Methods A cross-sectional study of the prevalence of CHD and cardiovascular risk factors in participants in the Australian Scleroderma Cohort Study was performed. Controls were drawn from the 2007–8 National Health Survey (NHS) and the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). OR and 95% CI were calculated to determine the prevalence of CHD and cardiovascular risk factors in SSc patients compared with controls.
Results Data were available for 850 SSc patients (86% female), 15 787 NHS participants (53% female) and 8802 AusDiab participants (56% female). Adjusted for age and gender, the OR of CHD in SSc patients was 1.9 (95% CI 1.4 to 2.4) compared with controls from AusDiab and 2.0 (95% CI 1.5 to 2.5) compared with controls from the NHS. The OR of CHD increased to 3.2 (95% CI 2.3 to 4.5) for SSc patients compared with controls from AusDiab after further adjustment for cardiovascular risk factors. Hypercholesterolaemia, diabetes mellitus and obesity were significantly less prevalent in the SSc cohort than in AusDiab. Within the SSc cohort, the presence of pulmonary arterial hypertension was associated with CHD.
Conclusions This is the first report of an increased prevalence of CHD in SSc patients. Further studies are required to determine the relative contribution of scleroderma-specific factors such as microvascular disease to the development of CHD.
Funding This study was supported by Scleroderma Australia. The Australian Scleroderma Cohort Study is funded by unrestricted educational grants from Actelion, Bayer, CSL, GSK and Pfizer. IPW is supported by an NHMRC clinical practitioner fellowship 1023407.
Ethics approval Approval for this project was obtained from the ethics committees covering each of the ASCS, NHS and AusDiab projects.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.