Article Text

PDF
AB0547 Cardiovascular Risk in Patients with Sjogren's Syndrome
  1. A.B.A. Garcia,
  2. V.F.M. Trevisani,
  3. L.P. Dardin,
  4. P.A. Milani,
  5. A. Czapkowski
  1. Federal University of Sao Paulo, São Paulo, Brazil

Abstract

Background The atherosclerosis is the principal cause of mortality in developed countries. Up to 75% of cardiovascular diseases can be explained by classic risk factors, like smoking, high blood pressure and sedentary lifestyle, but there is increasing evidence that chronic inflammation is an independent risk factor for accelerated atherosclerosis. Many studies show high cardiovascular risk in rheumatologic diseases and, recently, new data have revealed that patients with Sjogren's syndrome have a significantly higher risk for heart attack and stroke than general population.

Objectives The object of this study is to evaluate the cardiovascular risk in forty nine patients with Sjogren's syndrome.

Methods Traditional risk factors such as hypertension, diabetes, dyslipidaemia, smoking and family history of atherosclerosis have been assessed. Patients with prior cardiovascular events and personal history of atherosclerosis have been excluded. Clinical and laboratory features have been recorded, as well as the calculation of ESSDAI. The cardiovascular evaluation used de Framingham score, aerobic capacity (measured by ergospirometry), echocardiography, carotid intima-media thickness (CIMT), measured by ultrasonography, and ankle brachial index (ABI).

Results Fifteen patients (31%) had at least one traditional risk factor and 65,3% had ESSDAI score from mild to moderate. Thirty persons (61,22%) had Framingham score between moderate to high. Only 10,2% showed a good aerobic capacity and diastolic of left ventricular dysfunction was seen on 24 patients' echocardiography. Only two patients had increased CIMT, however, 66% presented ABI alterations.

Conclusions The statistical analysis demonstrated a positive association between the Framingham and ESSDAI scores [χ2(4)=10,858; p=0,028] and this could mean that the activity of the disease is an independent cardiovascular risk factor in Sjogren's syndrome.

References

  1. Magnus P, Beaglehole R. The real contribution of the major risk factors to the coronary epidemics: time to end the “only-50%” mith. Archieves of Internal Medicine 2001;161:2657-60.

  2. Beaglehole R, Magnus P. The search for new factors for coronary heart disease: occupational therapy for epidemiologists? Internal Journal of Epidemiology 2002;31:1117-22

  3. vab Leuven SI, Franssen R, Kastelein JJ, Levi M, Stroes ESG, Tak PP. Systemic inflammation as a risk factor for atherothrombosis. Rheumatology 2008;47:3-7.

  4. Peters MJ et al. Does rheumatoid arthritis equal diabetes mellitus as an independent risk factor for cardiovascular disease? A prospective study. Arthritis Rheum 2009;61:1571-79.

  5. Manzi S, Selzer F, Sutton-Tyrrel K, et al. Prevalence and risk factors of carotid plaque in women with Systemic lupus erythematosus. Arthritis Rheum 1999;42:51-60

  6. Vaudo G, Bocci EB, Shoenfeld Y, Schiallaci G, Wu R, Papa ND, Vitali C, Monache FD, Marchesi S, Mannarino E, Gerli R. Precocious intima-media thickening in patients with primary Sjogren's Syndrome. Arthritis Rheum 2005;52(12):3890-97.

  7. Avina-Zubieta A. Increased Cardiovascular Risk in Sjogren's Syndrome. EULAR 2014

  8. Gerli R, Bocci EB, Vaudo G, Marchesi S, Vitali C, Shoenfeld Y. Tradicional cardiovascular risk factors in primary Sjogren's syndrome – role of dyslipidaemia. Rheumatology 2006;45:1581082

Disclosure of Interest None declared

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.