Relation of Nailfold Capillaries and Autoantibodies to Mortality in Patients With Raynaud Phenomenon

Area of Science:

• Rheumatology
• Immunology
• Vascular Medicine

Background:

• Incipient Raynaud phenomenon diagnosis involves nailfold capillaroscopy and autoantibody tests to detect early connective tissue disease.
• The relationship between nailfold abnormalities, autoantibodies, and mortality in incipient Raynaud phenomenon remains unclear.

Purpose of the Study:

• To investigate the association between nailfold capillaroscopy findings, autoantibody status, and all-cause mortality in patients with incipient Raynaud phenomenon.

Main Methods:

• A cohort of 2958 patients with incipient Raynaud phenomenon underwent nailfold capillaroscopy and autoantibody testing (ANA, ANA subsets).
• Mortality data was collected over a median follow-up of 9.3 years and compared to a demographically matched standard population.
• Cox proportional hazards models were used to analyze the relationship between clinical factors and mortality.

Main Results:

• Patients with Raynaud phenomenon exhibited poorer survival than the general population (P<0.0001).
• Mortality rates were significantly higher in men than in women (P<0.0001).
• In women, abnormal nailfold capillaries, antinuclear antibodies (ANA), and anti-Scl-70 antibodies were linked to increased mortality. Combined abnormalities showed the highest risk. In men, these factors did not affect survival. Age and serum creatinine impacted mortality in both sexes.

Conclusions:

• Male sex, older age, and elevated serum creatinine are significant mortality predictors in Raynaud phenomenon.
• Abnormal nailfold capillaries and autoantibodies are associated with increased mortality in female patients with Raynaud phenomenon, but not in males.