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Updated: Jun 2, 2026
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Systemic sclerosis is an independent risk factor for increased coronary artery calcium deposition
Mo Yin Mok1, Chak Sing Lau, Sonny Sau Hin Chiu
1Queen Mary Hospital and University of Hong Kong, Hong Kong. temy@hkucc.hku.hk
Insights
Systemic sclerosis (SSc) is an independent risk factor for coronary artery calcification, even with lower traditional cardiovascular risks. Disease duration in SSc patients also correlates with coronary calcification severity.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Immunology
Background:
- Endothelial dysfunction and inflammation are key in systemic sclerosis (SSc) and atherosclerosis.
- Understanding cardiovascular risk in SSc is crucial due to shared pathogenic mechanisms.
Purpose of the Study:
- To investigate the relationship between coronary artery calcium score (CACS) and cardiovascular risk factors in SSc patients.
- To identify SSc as an independent determinant of coronary atherosclerosis.
Main Methods:
- Coronary artery calcium score (CACS) assessed via computed tomography.
- Comparison of cardiovascular risk factors between SSc patients and matched controls.
- Analysis of disease-specific factors including disease activity and inflammatory markers.
Main Results:
- SSc patients exhibited significantly lower LDL cholesterol and blood pressure compared to controls.
- A higher proportion of SSc patients had severe coronary calcification (CACS ≥ 101).
- SSc was an independent determinant of severe coronary calcification (OR 10.89), alongside age and LDL cholesterol. Disease duration was also associated with calcification.
Conclusions:
- Systemic sclerosis is an independent risk factor for coronary calcification.
- This finding is significant beyond conventional cardiovascular risk factors like age and hypertension.
- Disease duration in SSc independently predicts coronary calcification severity.
Objective:
Endothelial dysfunction and inflammation are pathogenic mechanisms common to systemic sclerosis (SSc) and atherosclerosis. This study was undertaken to examine the relationship between coronary atherosclerosis, as assessed by the coronary artery calcium score (CACS), and conventional cardiovascular and disease-specific risk factors in SSc patients.
Methods:
The CACS was measured by computed tomography, and cardiovascular risk factors were examined in SSc patients and compared with controls matched for age, sex, and glycemic status. Disease activity score, antiphospholipid antibodies, high-sensitivity C-reactive protein level, and erythrocyte sedimentation rate were measured in SSc patients. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined.
Results:
We recruited 53 SSc patients (50 women and 3 men) and 106 controls. The patients had a mean ± SD age of 53.1 ± 12.9 years and a median disease duration of 9 years. Compared to controls, SSc patients had significantly lower low-density lipoprotein (LDL) cholesterol levels (P = 0.001), high-density lipoprotein cholesterol levels (P = 0.01), diastolic blood pressure, waist circumference, and body mass index and were more likely to be receiving vasodilators (all P < 0.001). There was a significantly higher proportion of SSc patients among subjects with more severe coronary calcification (CACS ≥ 101) compared to those with lesser severity (CACS <100) (56.5% versus 29.4%; P = 0.01). Multiple logistic regression analysis revealed SSc to be an independent determinant for a CACS ≥ 101 (OR 10.89 [95% CI 2.21-53.75], P = 0.003) together with age and LDL cholesterol level after adjustment for other cardiovascular risk factors. Among disease-specific factors, only disease duration (OR 1.14 [95% CI 1.02-1.27], P = 0.02) was independently associated with more severe coronary calcification (CACS ≥ 101).
Conclusion:
Our findings indicate that SSc is an independent risk factor for coronary calcification, in addition to the conventional risk factors for coronary atherosclerosis, such as age and hypertension.
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