Primary Sjögren’s syndrome as independent risk factor for subclinical atherosclerosis

Novella-Navarro, Marta; Alarcón, José; Rosales-Alexander, José Luis; González-Martín, Jorge Juan; Carrión, Ofelia; Peña, Paloma García de la

doi:10.5152/eurjrheum.2021.20093

Cited by 7 publications

(3 citation statements)

References 24 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The increased prevalence of risk factors leading to increasing CV events, demands improvement in the prevention and management of pSS. In line with this a recent study showed a far higher prevalence for subclinical atherosclerosis in pSS compared to an age and sex matched control group ( 30 ). The authors report an association of an elevated erxthrocyte sedimentation rate and rheumatoid factor with subclinical atherosclerosis in pSS patients.…”

Section: Discussionsupporting

confidence: 74%

Premature stroke and cardiovascular risk in primary Sjögren's syndrome

Zippel

Beider

Kramer

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

IntroductionPrimary Sjögren's syndrome (pSS) is associated with an increased prevalence of traditional risk factors and cardiovascular diseases (CVDs). The study aimed to identify specific risk factors for CVD in pSS patients.MethodsPSS patients with and without CVD were compared. All patients fulfilled the EULAR/ACR classification criteria. Patients with CVD presented at least one of the following manifestations: myocardial infarction, transient ischemic attacks, ischemic or hemorrhagic stroke, peripheral artery disease, coronary artery disease, and carotid plaques. Data were collected by a standardized protocol and review of medical records.Results61/312 (19.6%) pSS patients presented with CVD. Traditional risk factors such as hypertension, hypercholesterinemia and diabetes (p < 0.05), pSS manifestations, in particular vasculitis (p = 0.033) and Raynaud's phenomenon (p = 0.018) were associated with CVD. Among patients with ischemic events (28/312, 9%), particularly cerebrovascular disease (n = 12/28, 42.9%), correlations with increased EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) (p = 0.039) and EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) (p = 0.048) were observed. Age at first cerebrovascular event was 55.2 [48.9–69.6] years. Multivariate analysis confirmed hypertension [odds ratio (OR) 3.7, 95% confidence interval (CI) 1.87–7.18, p < 0.001], hypercholesterinemia (OR 3.1, 95% CI 1.63–5.72, p < 0.001), male gender (OR 0.4, 95% CI 0.17–0.78, p = 0.009), Raynaud's phenomenon (OR 2.5, 95% CI 1.28–4.82, p = 0.007), and CNS involvement (OR 2.7, 95% CI 1.00–7.15, p = 0.048) as independent CVD predictors.ConclusionRaynaud's phenomen as well as vasculitis and high ESSDAI have shown a significant association to CVD. PSS patients with cerebrovascular events were younger than expected. Knowledge about risk factors may help clinicians to identify pSS patients at risk for CVD. After diagnosis of pSS, patients should be screened for risk factors such as hypertension and receive appropriate therapy to prevent or at least reduce sequelae such as infarction. However, further investigations are necessary in order to achieve a reliable risk stratification for these patients.

show abstract

Section: Discussionsupporting

confidence: 74%

Premature stroke and cardiovascular risk in primary Sjögren's syndrome

Zippel

Beider

Kramer

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…Ergänzend hierzu zeigte sich langfristig ein deutlich erhöhtes kardiovaskulären Risiko und das auf bis zu 5 % erhöhte Lymphomrisiko, welches mit klaren Risikofaktoren (s. Infobox) assoziiert wurde [12,13].…”

Section: Komorbiditäten Im Blick Behaltenunclassified

Das Sjögren-Syndrom im Fokus

Zehrfeld,

Witte,

Ernst

2024

Dtsch Med Wochenschr

View full text Add to dashboard Cite

Was ist neu? Diagnostik – Der Teufel steckt im Detail! Die Speicheldrüsensonografie (SGUS) hat sich in der Diagnostik des Sjögren-Syndroms (SjS) etabliert und kann zu einer höheren Sensitivität der geltenden Klassifikationskriterien führen, gleichwohl sie bislang nicht in die Kriterien aufgenommen wurde. In der Labordiagnostik erhalten die Subspezifizierung von anti-SSA/Ro-Antikörpern – ggf. auch neue Biomarker – eine zunehmende Bedeutung. Präventiv müssen psychische Belastungen im Auge behalten werden, und das kardiovaskuläre Risiko und das Lymphomrisiko spielen eine große Rolle. Mittels Cluster-Analysen konnten verschiedene Phänotyp-Gruppen erschlossen werden, denen sich klinische Parameter zuordnen lassen. Therapie 2020 wurden Therapieempfehlungen publiziert, die sich an den klinischen Manifestationen des SjS orientieren und Medikamente empfehlen, die auch in der Therapie des systemischen Lupus erythematodes (SLE) oder bei der rheumatoiden Arthritis eingesetzt werden. In den EULAR-Empfehlungen hat die Anti-B-Zell-Therapie mit Rituximab und Belimumab für schwerwiegende Manifestationen Einzug gefunden, und Ianalumab ist ein weiterer aussichtsreicher Wirkstoff. Ein weiterer Schwerpunkt der aktuellen Forschung liegt in der Inhibition der Costimulation zwischen Immunzellen. Nach zuletzt enttäuschenden Ergebnissen von Abatacept sind mit Iscalimab und Dazodalibep aber auch auf dieser Therapieachse aussichtsreiche Wirkstoffe in der Pipeline.

show abstract

“…Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease that primarily affects the exocrine glands through lymphocytic infiltration. 1 The prevalence, reported in the literature ranges from 1:100 to 1:1000, making pSS the most common connective tissue disease in middle-aged people. 2 In addition, approximately 50% of patients with pSS present extraglandular manifestations.…”

Section: Introductionmentioning

confidence: 99%

Primary Sjögren’s syndrome independently promotes premature subclinical atherosclerosis

Zehrfeld,

Abelmann,

Benz

et al. 2024

RMD Open

View full text Add to dashboard Cite

ObjectivesCardiovascular comorbidities are common in patients with autoimmune diseases. This study investigates the extent of subclinical atherosclerosis in patients with primary Sjögren’s syndrome (pSS). Correlations with clinical factors such as organ involvement (OI) or disease activity were analysed and oxLDL antibodies (oxLDL ab) were measured as potential biomarkers of vascular damage.MethodsPatients with pSS were consecutively included from the rheumatology outpatient clinic. Age- and sex-matched controls were recruited (2:1 ratio). Data collection was performed by a standardised questionnaire and Doppler ultrasound to evaluate the plaque extent and carotid intima-media thickness (cIMT). Propensity score matching included all cardiovascular risk (CVR) factors and corresponding laboratory markers.ResultsData were available for 299 participants (199 pSS/100 controls), aged 59.4 years (50.6–65.0), 19.1% male. After matching, the pSS cohort had greater cIMT (p<0.001) and plaque extent (OR=1.82; 95% CI 1.14 to 2.95). Subgroup analyses of patients with pSS revealed that OI was associated with increased cIMT (p=0.025) and increased plaque occurrence compared with patients without OI (OR=1.74; 95% CI 1.02 to 3.01). OxLDL ab tended to be lower in patients with plaque (p=0.052). Correlations of higher Oxidized Low Density Lipoprotein (oxLDL) ab with EULAR Sjögren’s Syndrome Disease Activity Index (p<0.001) and anti–Sjögren's-syndrome-related antigen A autoantibodies (SSA/Ro antibodies) (p=0.026) were observed.ConclusionsSubclinical atherosclerosis occurs earlier and more severely in patients with pSS. The difference in cIMT between pSS and controls seems mainly driven by patients with OI, suggesting that this subgroup is particularly at risk. OxLDL ab might protect against atherosclerotic progression in patients with pSS. CVR stratification and preventive medications such as Hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors should be discussed and further longitudinal studies are needed.

show abstract

Primary Sjögren’s syndrome as independent risk factor for subclinical atherosclerosis

Cited by 7 publications

References 24 publications

Premature stroke and cardiovascular risk in primary Sjögren's syndrome

Premature stroke and cardiovascular risk in primary Sjögren's syndrome

Das Sjögren-Syndrom im Fokus

Primary Sjögren’s syndrome independently promotes premature subclinical atherosclerosis

Contact Info

Product

Resources

About