Risk of Coronary Artery Disease in Patients With Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis

Li, Huimin; Qian, Tong; Guo, Lirong; Yu, Shui; Li, Yuewei; Cao, Qinqin; Li, Jinwei; Li, Feng

doi:10.1016/j.amjms.2018.08.001

Cited by 22 publications

(11 citation statements)

References 34 publications

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“…Autoimmune inflammatory diseases are associated with an increased risk of coronary artery disease, hypothesised to be the result of chronic inflammation leading to accelerated atherosclerosis [25][26][27]. Unlike other autoimmune diseases, chronic inflammation is a less prominent feature of SSc, but the progression of the disease is characterised by an obliterative small vessel vasculopathy [28].…”

Section: Coronary Artery Diseasementioning

confidence: 99%

Sudden Cardiac Death in Systemic Sclerosis: Diagnostics to Assess Risk and Inform Management

et al. 2021

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Cardiac disease is a leading cause of death in systemic sclerosis (SSc) and sudden cardiac death (SCD) is thought to occur more commonly in SSc than in the general population. Diffuse myocardial fibrosis, myocarditis and ischaemic heart disease are all prevalent in SSc and can be reasonably hypothesised to contribute to an increased risk of SCD. Despite this, SCD remains a relatively understudied area of SSc with little understood about SSc-specific risk factors and opportunities for primary prevention. In this review, we present an overview of the possible mechanisms of SCD in SSc and our current understanding of how each of these mechanisms may contribute to cardiac death. This review highlights the need for a future research agenda that addresses the underlying epidemiology of SCD in SSc and identifies opportunities for intervention to modify the disease course of heart disease in SSc.

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Section: Coronary Artery Diseasementioning

confidence: 99%

Sudden Cardiac Death in Systemic Sclerosis: Diagnostics to Assess Risk and Inform Management

et al. 2021

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“…It is worth mentioning that multiple studies have exhibited a strict association between connective tissue diseases (CTDs) and CHD risk, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc), but the risk of CHD in IIMs patients is still inconclusive due to the conflicting epidemiological studies (8)(9)(10). Some studies demonstrated an increased risk of CHD among IIMs patients compared with the general population (11)(12)(13)(14)(15)(16), but the study by Linos et al found that there was no significant association between DM and CHD risk (17).…”

Section: Introductionmentioning

confidence: 99%

Coronary Heart Disease and Cardiovascular Risk Factors in Patients With Idiopathic Inflammatory Myopathies: A Systemic Review and Meta-Analysis

Luo

Chen

et al. 2022

Front. Med.

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Objectives:It is well-established that the association between atherosclerotic cardiovascular diseases (ASCVD) and connective tissue diseases (CTDs), but the relationship between coronary heart disease (CHD) and idiopathic inflammatory myopathies (IIMs) remains controversial yet. The aim of this meta-analysis is to systematically evaluate the risk of CHD in IIMs patients. In addition, we explore differences in traditional cardiovascular risk factors between IIMs patients and controls.Methods:We searched Pubmed, EMBASE and Cochrane databases to identify relevant observational studies published in English up to August 2021. Pooled relative risk (RR) and 95% confidence interval (CI) was calculated using the generic inverse variance method for the risk of CHD. A meta-proportion analysis was conducted to assess differences in cardiovascular risk factors between two groups.Results:A total of 15 studies met inclusion criteria: seven studies focused on CHD and nine studies focused on traditional cardiovascular risk factors. The results demonstrated that IIMs patients had a higher risk of CHD (RR = 2.19, 95% CI: 1.40–3.42). Hypertension (OR = 1.44, 95% CI: 1.28–1.61), diabetes mellitus (OR = 1.67, 95% CI: 1.55–1.81) and dyslipidemia (OR = 1.48, 95% CI: 1.19–1.84) were more prevalent in IIMs patients compared with controls. However, there was a significant heterogeneity among studies assessing the risk of CHD and hypertension. Subgroup analysis demonstrated that definition of CHD, country and sample size may be potential sources of heterogeneity.Conclusions:IIMs patients were at increased risk of CHD, and traditional cardiovascular risk factors appeared more prevalent in IIMs patients. This systemic review offers the proof that early appropriate interventions could reduce cardiovascular-associated morbidity and mortality in IIMs patients.

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“…Systemic lupus erythematosus (SLE) is a chronic inflammatory disease, which affects all organ systems [12•]. It is classified as a systemic autoimmune disease of unknown etiology, with a prevalence of 20-70 per 100,000 that is 6 times greater in women than men, and a peak onset between 15 and 40 years of age [13][14][15]. SLE is characterized by over-reactive and auto-reactive T cells, which distort normal cytokine production, resulting in increased inflammation and multi-organ tissue damage.…”

Section: Systemic Lupus Erythematosus and Antiphospholipid Syndromementioning

confidence: 99%

Disorders of the Aorta and Aortic Valve in Connective Tissue Diseases

et al. 2020

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Purpose of Review The incidence of aortic valve disease in inherited connective tissue disorders is well documented; however, recent studies have only begun to unravel the pathology behind this association. In this review, we aim to describe the etiology, clinical manifestations, management, and prognosis of aortic and aortic valvular disorders that co-exist in a variety of connective tissue diseases. An extensive literature review was performed in PubMed. Articles from 2008 to 2018 were included for review. Predetermined search terms used in PubMed include "aortic manifestation of connective tissue diseases" and "aortic valve disorders in rheumatologic disease." Recent Findings Manifestations of aortic valve disease in the context of connective tissue disorders include valvular stenosis, regurgitation, and/or thoracic aortic aneurysms. Both inherited and inflammatory connective tissue disorders contribute to aortic valve damage with increased susceptibility associated with specific gene variants. Summary Anti-inflammatory and immunosuppressive therapies have demonstrated beneficial results in Marfan's syndrome, Behcet disease, rheumatoid arthritis, ankylosing spondylitis, and systemic sclerosis, often leading to remission. Yet, such therapy is less effective in other disorders compared to alternative treatments such as surgical intervention. Additionally, regular echocardiographic studies should be recommended to those suffering from these disorders, especially those at higher risk for cardiovascular involvement. Given the rates of relapse with immunosuppressants, even following aortic valve replacement, further studies are needed to determine if certain dosing and/or combinations of immunosuppressants could be given to those diagnosed with connective tissue diseases to prevent progression of aortic valve involvement.

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Risk of Coronary Artery Disease in Patients With Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis

Cited by 22 publications

References 34 publications

Sudden Cardiac Death in Systemic Sclerosis: Diagnostics to Assess Risk and Inform Management

Sudden Cardiac Death in Systemic Sclerosis: Diagnostics to Assess Risk and Inform Management

Coronary Heart Disease and Cardiovascular Risk Factors in Patients With Idiopathic Inflammatory Myopathies: A Systemic Review and Meta-Analysis

Disorders of the Aorta and Aortic Valve in Connective Tissue Diseases

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