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Increased risk of acute myocardial infarction in systemic sclerosis: a nationwide population-based study

Szu-Ying Chu1, Yi-Ju Chen, Chia-Jen Liu

  • 1Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Dermatology, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.

The American Journal of Medicine
|October 26, 2013
PubMed

Insights

Systemic sclerosis significantly increases the risk of acute myocardial infarction. Current immunosuppressors did not demonstrate a reduced risk in patients with this autoimmune condition.

Area of Science:

  • Cardiology
  • Rheumatology
  • Epidemiology

Background:

  • Systemic sclerosis (SSc) is a severe autoimmune disease with high rates of cardiac involvement.
  • Acute myocardial infarction (AMI) risk in SSc patients lacks large-scale epidemiological data.
  • Vasculopathy in SSc contributes to myocardial damage.

Purpose of the Study:

  • To assess the hazard ratio (HR) for AMI in SSc patients.
  • To identify risk factors for AMI in SSc.
  • To compare AMI risk among SSc patients using different immunosuppressors.

Main Methods:

  • A cohort of 1344 SSc patients and 13,440 matched controls (1997-2006) from Taiwan's National Health Insurance Research Database.
  • Cox proportional hazards model used to calculate adjusted HRs for AMI.
  • Comparison of AMI risk between SSc patients on immunosuppressors versus those not on them.

Main Results:

  • SSc is an independent risk factor for AMI (adjusted HR 2.45).
  • Hypertension (HR 2.08) and diabetes (HR 2.14) were significant risk factors for AMI.
  • Immunosuppressors (steroids, penicillamine, cyclophosphamide, azathioprine, methotrexate, cyclosporine) did not reduce AMI risk in SSc patients.

Conclusions:

  • Systemic sclerosis is independently linked to a higher risk of acute myocardial infarction.
  • Current immunosuppressive therapies do not appear to mitigate AMI risk in SSc patients.
  • Further research is needed to understand and manage cardiovascular risk in SSc.
Abstract

Keywords:
Cardiovascular riskCoronary artery diseaseImmunosuppressorMyocardial infarctionSystemic sclerosis

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