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Atherosclerosis in systemic sclerosis: a systematic review and meta-analysis.
Karen Au1, Manjit K Singh, Vijay Bodukam
1University of California, Los Angeles, CA, USA.
Arthritis and Rheumatism
|April 12, 2011
Summary
Systemic sclerosis (SSc) patients show a higher risk of atherosclerosis compared to healthy individuals. This systematic review and meta-analysis confirms increased carotid intima-media thickness and reduced flow-mediated dilation in SSc patients.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Biology
Background:
- Systemic sclerosis (SSc) is linked to vascular complications including calcification and endothelial damage, potentially increasing cardiovascular disease risk.
- Atherosclerosis development is a concern in SSc, necessitating a clear understanding of this association.
Purpose of the Study:
- To systematically review and meta-analyze existing studies.
- To determine if SSc patients have an elevated risk of atherosclerosis compared to healthy controls.
Main Methods:
- Systematic literature search of PubMed and Cochrane databases up to May 2010, including recent abstracts.
- Inclusion of 31 studies comparing atherosclerosis markers (angiography, Doppler ultrasound, CT, MRI, FMD%, ABI, autopsy) in SSc patients versus controls.
- Meta-analysis of carotid intima-media thickness (IMT) and flow-mediated dilation (FMD%) data, with meta-regression for IMT predictors.
Main Results:
- SSc patients exhibited higher prevalence of coronary atherosclerosis, peripheral vascular disease, and cerebrovascular calcification.
- Meta-analysis revealed significantly increased carotid IMT (0.11 mm) and decreased FMD% (-3.07%) in SSc patients compared to controls.
- Study heterogeneity was mainly due to variations in disease duration and age differences between groups.
Conclusions:
- Patients with systemic sclerosis face a significantly increased risk of atherosclerosis.
- Further research is warranted to fully elucidate the underlying mechanisms driving this heightened cardiovascular risk in SSc.
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