Related Experiment Video
Updated: Jun 23, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Association of Autoimmune Diseases With Coronary Atherosclerosis Severity and Ischemic Events
Martin Bødtker Mortensen1, Jesper Møller Jensen2, Niels Peter Rønnow Sand3
1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Insights
Autoimmune diseases increase the risk of atherosclerotic cardiovascular disease (ASCVD) and coronary atherosclerosis. Controlling traditional cardiovascular risk factors is crucial for improving outcomes in these patients.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Immunology
Background:
- Autoimmune diseases are linked to increased risk of atherosclerotic cardiovascular disease (ASCVD).
- The mechanisms and impact of traditional risk factors in this context are not fully understood.
Purpose of the Study:
- To investigate the independent association between autoimmune diseases and coronary atherosclerosis.
- To determine if traditional cardiovascular risk factors modulate ASCVD risk in patients with autoimmune diseases.
Main Methods:
- Analysis of 85,512 patients from the Western Denmark Heart Registry using coronary computed tomography angiography.
- Assessment of diagnoses for 18 autoimmune diseases.
- Calculation of adjusted odds ratios (aOR) for coronary atherosclerosis and adjusted hazard ratios (aHR) for ASCVD events.
Main Results:
- Autoimmune diseases were independently associated with a higher burden of coronary atherosclerosis, including any plaque, any coronary artery calcification (CAC), and severe CAC.
- Patients with autoimmune diseases had a 46% higher risk of ASCVD events.
- Favorable cardiovascular risk factor profiles in autoimmune patients significantly reduced ASCVD risk.
Conclusions:
- Autoimmune diseases are independently linked to increased coronary atherosclerosis and ASCVD risk.
- Risk is exacerbated by traditional cardiovascular risk factors, suggesting accelerated atherogenesis.
- Effective management of cardiovascular risk factors is vital for improving prognosis in patients with autoimmune diseases.
Background:
Some autoimmune diseases carry elevated risk for atherosclerotic cardiovascular disease (ASCVD), yet the underlying mechanism and the influence of traditional risk factors remain unclear.
Objectives:
This study sought to determine whether autoimmune diseases independently correlate with coronary atherosclerosis and ASCVD risk and whether traditional cardiovascular risk factors modulate the risk.
Methods:
The study included 85,512 patients from the Western Denmark Heart Registry undergoing coronary computed tomography angiography. A diagnosis of 1 of 18 autoimmune diseases was assessed. Adjusted OR (aOR) for any plaque, any coronary artery calcification (CAC), CAC of >90th percentile, and obstructive coronary artery disease as well as adjusted HR (aHR) for ASCVD were calculated.
Results:
During 5.3 years (Q1-Q3: 2.8-8.2 years) of follow-up, 3,832 ASCVD events occurred. A total of 4,064 patients had a diagnosis of autoimmune disease, which was associated with both presence of any plaque (aOR: 1.29; 95% CI: 1.20-1.40), any CAC (aOR: 1.28; 95% CI: 1.19-1.37), and severe CAC of >90th percentile (aOR: 1.53; 95% CI: 1.39-1.68), but not with having obstructive coronary artery disease (aOR: 1.04; 95% CI: 0.91-1.17). Patients with autoimmune diseases had a 46% higher risk (aHR: 1.46; 95% CI: 1.29-1.65) for ASCVD. Traditional cardiovascular risk factors were strongly associated with future ASCVD events, and a favorable cardiovascular risk factor profile in autoimmune patients was associated with ∼54% lower risk compared to patients with presence of risk factors (aHR: 0.46; 95% CI: 0.27-0.81).
Conclusions:
Autoimmune diseases were independently associated with higher burden of coronary atherosclerosis and higher risk for future ASCVD events, with risk accentuated by traditional cardiovascular risk factors. These findings suggest that autoimmune diseases increase risk through accelerated atherogenesis and that cardiovascular risk factor control is key for improving prognosis in patients with autoimmune diseases.
Related Concept Videos
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:29Autoimmune Disorders
Concept and Mechanism of Autoimmune Diseases
The immune...
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:38Inflammation
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications