AB0810 A comparison of clinical presentation and incidence rate of cardiopulmonary involvement between male and female patients with early systemic sclerosis

Abstract

BackgroundData regarding the incidence rate (IR) of cardiopulmonary involvement in comparison between male and female patients with early systemic sclerosis (SSc) are limited.ObjectivesTo compare the prevalence of clinical manifestations and the IR of cardiopulmonary involvement comparing between male and female patients with early SSc.MethodsAn inception cohort of early SSc patients (disease duration ≤3 years from the first non-Raynaud’s phenomenon) seen at the Rheumatology clinic, Maharaj Nakorn Chiang Mai Hospital, Thailand, between January 2010 and June 2016, was used. All patients were assessed for clinical manifestations and underwent ECG, echocardiography, and HRCT at the study entry and every 12 months thereafter. In the last visit, the cumulative clinical manifestations were recorded. Patients who continue to follow up at least 12 months were included for analysis.ResultsOne hundred and fifteen patients (89 dcSSc) with a mean (SD) disease duration of 11.6 (8.8) months at cohort entry were enrolled during a mean (SD) observation period of 3.8 (1.6) years. There were 46 male patients (40%). Tests for anti-topoisomerase I and anti-centromere antibodies were positive in 91 (79.1%) and 7 (6.1%) patients, respectively. The male group had higher prevalence of dcSSc subtype (91.3% vs. 69.5%,p=0.006) and positive test for anti-topoisomerase I antibody (89.1% vs. 72.5%,p=0.031) compared with the female group. At enrollment, the male group had higher prevalence of hypo-hyperpigmentation (84.8% vs. 65.2%,p=0.021), suspected myositis (26.1% vs. 10.1%,p=0.024), and right ventricular dysfunction (8.7% vs. 0%,p=0.024) compared with the female group. In the last visit, the male group had higher cumulative prevalence of digital ulcer (47.8% vs. 27.5%,p=0.026), telangiectasia (93.5% vs. 69.6%,p=0.002), joint contracture (69.6% vs. 43.5%,p=0.006), tendon friction rub (39.1% vs. 20.3%,p=0.027), LVEF <50% (21.7% vs. 8.7%,p=0.048) and right ventricular dysfunction (34.8% vs. 7.2%,p<0.001) compared with the female group. The male group had significant higher IR of right ventricular dysfunction (8.21 vs. 1.99 per 100 person-years,p=0.006) and interstitial lung disease (ILD) determined by HRCT (63.66 vs. 39.19 per 100 person-years,p=0.022) compared to the female group. However, no significant IR of LVEF <50% (5.63 vs. 2.10 per 100 person-years,p=0.078), and elevated systolic pulmonary artery pressure ≥50 mmHg determined by echocardiography (2.81 vs. 1.55 per 100 person-years,p=0.339) were observed among the two groups.ConclusionsOur study cohort found that male gender had higher proportion of dcSSc subtype and had more severe clinical manifestations compared with female. In addition, during the follow-up period, the IR of right ventricular dysfunction and ILD were higher in male than that in female patients in the early stage of SSc.Disclosure of InterestNone declared