Background In Systemic Sclerosis (SSc), data on prevalence of traditional cardiovascular (CV) disease risk factors is scarce and conflicting (1). Therefore, SSc patients CV risk attributed to traditional CV risk factors remains an issue of debate.
Objectives To evaluate if patients with SSc have a higher prevalence of traditional CV disease risk factors and a higher risk of long-term CV events based on the risk prediction tool of the Framingham risk score (FRS) in comparison with age, race and sex matched control subjects.
Methods The study comprised patients diagnosed with SSc, fulfilling both the 1980 ACR and the 2013 ACR/EULAR criteria for the disease, and followed-up at our Rheumatology Department and a group of age, race and sex-matched controls. Inclusion criteria were age 30 to 74 and no history of CV events in order to calculate FRS. In total, 46 out of 62 patients were eligible for the study. Traditional CV disease risk factors (diabetes, arterial hypertension and smoking) were compared among the 46 patients with SSc and 51 matched controls. Systolic blood pressure (SBP) values and total and high-density lipoprotein (HDL) cholesterol levels were also collected. The 10-year risk for CV events according to FRS was calculated and means of patients and controls were compared. Subjects' distribution into 3 categories of risk – low (<10% risk), medium (10–20% risk) and high (>20% risk) was also compared. Parametric and nonparametric tests were used for comparison between groups. P value <0.05 was defined as statistically significant.
Results Mean risk for CV events in 10-years assessed by FRS was 10.00%±8.61 for SSc patients and 7.76%±8.30 for matched controls. Differences were not statistically significant (p=0.196). Additionally, prevalence of diabetes, arterial hypertension and smoking did not differ significantly between the two groups (p=0.890, p=0.443, p=0.651, respectively). Total and HDL cholesterol levels were also similar between groups (p=0.963 and p=0.506, respectively). Only SBP values (mmHg) of SSc patients were significantly higher (128.50 mmHg [113.5 to 139.3]) (median [interquartile range]) compared with controls (120.00 [110 to 130]), p=0.031. Subjects' distribution into the 3 groups of risk defined was similar for both groups (p=0.205).
Conclusions In our study, prevalence of traditional CV disease risk factors and 10-year risk for CV events based on FRS assessment tool did not differ significantly between SSc patients and age, sex and race matched controls.
Psarras A, Soulaidopoulos S, Garyfallos A, Kitas G and Dimitroulas T. A critical view on cardiovascular risk in systemic sclerosis. Rheumatol Int. 2017 Jan;37(1):85–95.
Disclosure of Interest None declared