May 11, 2011
Study Suggests Systemic Sclerosis Is An Independent Risk Factor For Atherosclerosis
Age and hypertension contribute to coronary calcification -- similar to general population
A new study by researchers in Hong Kong suggests that systemic sclerosis is an independent determinant for moderate to severe coronary calcification or atherosclerosis. Conventional cardiovascular risk factors such as age and hypertension predispose patients with systemic sclerosis to plaque build-up in the heart arteries similar to the general population. Details of this study are now available in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).
In the current study a research team, led by Dr. Mo Yin Mok of the Queen Mary Hospital and the University of Hong Kong, recruited 53 patients with systemic sclerosis (50 female, 3 male) and 106 healthy controls to examine coronary artery calcium scores (CACS) and cardiovascular risk factors. Disease activity score, antiphospholipid antibodies, C-reactive protein, and erythrocyte sedimentation rate were also measured for scleroderma patients.
Researchers found that 57% of patients with systemic sclerosis had moderate to severe coronary calcification (CACS greater than 101) compared to only 29% of controls. Scleroderma patients also had significantly lower LDL-cholesterol, HDL-cholesterol, and diastolic blood pressure compared to healthy controls. In addition, compared to the control group, roughly one-third of patients had a low body mass index (BMI) and would be considered underweight according to recommended BMI cutoffs for Asian populations.
Regression analysis also showed that systemic sclerosis was an independent risk factor for coronary artery calcification (odds ratio of 10.89), and disease duration was associated with more severe atherosclerosis. The results of this study concur with previous reports of increased atherosclerosis as determined by angiography in patients with systemic sclerosis. "Our findings show that systemic sclerosis patients have an 11-fold increased risk for developing moderate to severe coronary calcification after adjustment for normal cardiovascular risk factors," concluded Dr. Mok. "CAD is a major global health concern, and further studies should explore modifiable disease-specific risk factors in scleroderma patients that could inhibit coronary calcification in this population."
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