Article Text

PDF
Extended report
The risk of cardiovascular disease in systemic sclerosis: a population-based cohort study
  1. Ada Man1,
  2. Yanyan Zhu2,
  3. Yuqing Zhang2,
  4. Maureen Dubreuil1,
  5. Young Hee Rho2,
  6. Christine Peloquin2,
  7. Robert W Simms1,
  8. Hyon K Choi1,2
  1. 1Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA
  2. 2The Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Ada Man, Arthritis Center/Rheumatology, Boston University School of Medicine, 72 East Concord Street, Evans 501, Boston, Massachusetts 02118, USA; adaman{at}bu.edu

Abstract

Objectives To evaluate the risk of incident myocardial infarction (MI), stroke and peripheral vascular disease (PVD) in individuals with systemic sclerosis (SSc) in a general population context.

Methods We conducted a cohort study using a UK primary care database containing records from 1986 to 2011. SSc diagnoses, outcomes and cardiovascular risk factors were identified from electronic medical records. We conducted two cohort analyses: (1) MI and stroke, and (2) PVD, excluding individuals with prevalent disease at baseline for each analysis. We estimated HRs comparing SSc with age-, sex- and entry time-matched comparison cohorts, adjusting for potential cardiovascular risk factors.

Results Among 865 individuals with SSc (85.8% women, mean age 58.7 years), the incidence rates (IRs) of MI and stroke were 4.4 and 4.8 per 1000 person-years (PY), versus 2.5 and 2.5 per 1000 PY in the comparison cohort. The corresponding adjusted HRs were 1.80 (95% CI 1.07 to 3.05) for MI and 2.61 (95% CI 1.54 to 4.44) for stroke. Among 858 individuals with SSc (85.3% female, mean age 58.9 years), the IR of PVD was 7.6 per 1000 PY versus 1.9 per 1000 PY in the comparison cohort, with an adjusted HR of 4.35 (95% CI 2.74 to 6.93).

Conclusions These findings provide the first general population-based evidence that SSc is associated with an increased risk of developing MI, stroke and PVD. Further insight into disease mechanisms, as well as how disease subtype, organ involvement and medication use may alter these increased risks, is needed.

  • Systemic Sclerosis
  • Cardiovascular Disease
  • Atherosclerosis
  • Epidemiology

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.