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Is atherosclerosis accelerated in systemic sclerosis? Novel insights
Alessandra Soriano1, Antonella Afeltra, Yehuda Shoenfeld
1aDepartment of Clinical Medicine and Rheumatology, Campus Bio-Medico University, Rome, Italy bZabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer cIncumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Current Opinion in Rheumatology
|September 9, 2014
Summary
Systemic sclerosis (SSc) patients face increased cardiovascular disease mortality. While coronary heart disease risk is higher, evidence for accelerated atherosclerosis is inconclusive, necessitating further research into underlying mechanisms.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Pathophysiology
Background:
- Cardiovascular disease (CVD) mortality is rising in systemic sclerosis (SSc).
- Accelerated atherosclerosis is suspected but not fully established in SSc.
- Comparison with rheumatoid arthritis and systemic lupus erythematosus suggests potential parallels.
Purpose of the Study:
- Review recent evidence on pathogenic mechanisms of atherosclerosis in SSc.
- Examine microvascular and macrovascular disease in SSc.
- Evaluate surrogate measures for subclinical atherosclerosis detection in SSc patients.
Main Methods:
- Literature review of recent evidence.
- Analysis of cohort studies on coronary heart disease risk.
- Assessment of diagnostic techniques for atherosclerosis detection.
Main Results:
- SSc patients exhibit a significantly higher risk of coronary heart disease.
- No significant difference in atherosclerotic plaque or intima-media thickness was observed.
- The diagnostic value of cardiac MRI for SSc heart disease requires further determination.
Conclusions:
- Microvascular disease is characteristic of SSc.
- Mechanisms behind accelerated atherosclerosis and macrovascular disease in SSc remain unclear.
- Future research should explore genetic, environmental, and ethnic factors influencing these processes.
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