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Article: Systemic sclerosis is an independent risk factor for increased coronary artery calcium deposition
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TitleSystemic sclerosis is an independent risk factor for increased coronary artery calcium deposition
 
AuthorsMok, MY1
Lau, CS1
Chiu, SSH1
Tso, AWK1
Lo, Y1
Law, LSC1
Mak, KF1
Wong, WS1
Khong, PL1
Lam, KSL1
 
Issue Date2011
 
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0004-3591/
 
CitationArthritis And Rheumatism, 2011, v. 63 n. 5, p. 1387-1395 [How to Cite?]
DOI: http://dx.doi.org/10.1002/art.30283
 
AbstractObjective: Endothelial dysfunction and inflammation are pathogenic mechanisms common to systemic sclerosis (SSc) and atherosclerosis. This study was undertaken to examine the relationship between coronary atherosclerosis, as assessed by the coronary artery calcium score (CACS), and conventional cardiovascular and disease-specific risk factors in SSc patients. Methods: The CACS was measured by computed tomography, and cardiovascular risk factors were examined in SSc patients and compared with controls matched for age, sex, and glycemic status. Disease activity score, antiphospholipid antibodies, high-sensitivity C-reactive protein level, and erythrocyte sedimentation rate were measured in SSc patients. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined. Results: We recruited 53 SSc patients (50 women and 3 men) and 106 controls. The patients had a mean ± SD age of 53.1 ± 12.9 years and a median disease duration of 9 years. Compared to controls, SSc patients had significantly lower low-density lipoprotein (LDL) cholesterol levels (P = 0.001), high-density lipoprotein cholesterol levels (P = 0.01), diastolic blood pressure, waist circumference, and body mass index and were more likely to be receiving vasodilators (all P < 0.001). There was a significantly higher proportion of SSc patients among subjects with more severe coronary calcification (CACS 101) compared to those with lesser severity (CACS <100) (56.5% versus 29.4%; P = 0.01). Multiple logistic regression analysis revealed SSc to be an independent determinant for a CACS 101 (OR 10.89 [95% CI 2.21-53.75], P = 0.003) together with age and LDL cholesterol level after adjustment for other cardiovascular risk factors. Among disease-specific factors, only disease duration (OR 1.14 [95% CI 1.02-1.27], P = 0.02) was independently associated with more severe coronary calcification (CACS 101). Conclusion: Our findings indicate that SSc is an independent risk factor for coronary calcification, in addition to the conventional risk factors for coronary atherosclerosis, such as age and hypertension. Copyright © 2011 by the American College of Rheumatology.
 
ISSN0004-3591
2012 Impact Factor: 7.477
2012 SCImago Journal Rankings: 3.012
 
DOIhttp://dx.doi.org/10.1002/art.30283
 
ISI Accession Number IDWOS:000290609800028
Funding AgencyGrant Number
Hong Kong Arthritis and Rheumatism Foundation
Merck Sharpe Dohme
Roche
Pfizer
Novartis
Johnson Johnson
Funding Information:

Supported by the Hong Kong Arthritis and Rheumatism Foundation Research Fund.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorMok, MY
 
dc.contributor.authorLau, CS
 
dc.contributor.authorChiu, SSH
 
dc.contributor.authorTso, AWK
 
dc.contributor.authorLo, Y
 
dc.contributor.authorLaw, LSC
 
dc.contributor.authorMak, KF
 
dc.contributor.authorWong, WS
 
dc.contributor.authorKhong, PL
 
dc.contributor.authorLam, KSL
 
dc.date.accessioned2011-07-27T01:29:56Z
 
dc.date.available2011-07-27T01:29:56Z
 
dc.date.issued2011
 
dc.description.abstractObjective: Endothelial dysfunction and inflammation are pathogenic mechanisms common to systemic sclerosis (SSc) and atherosclerosis. This study was undertaken to examine the relationship between coronary atherosclerosis, as assessed by the coronary artery calcium score (CACS), and conventional cardiovascular and disease-specific risk factors in SSc patients. Methods: The CACS was measured by computed tomography, and cardiovascular risk factors were examined in SSc patients and compared with controls matched for age, sex, and glycemic status. Disease activity score, antiphospholipid antibodies, high-sensitivity C-reactive protein level, and erythrocyte sedimentation rate were measured in SSc patients. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined. Results: We recruited 53 SSc patients (50 women and 3 men) and 106 controls. The patients had a mean ± SD age of 53.1 ± 12.9 years and a median disease duration of 9 years. Compared to controls, SSc patients had significantly lower low-density lipoprotein (LDL) cholesterol levels (P = 0.001), high-density lipoprotein cholesterol levels (P = 0.01), diastolic blood pressure, waist circumference, and body mass index and were more likely to be receiving vasodilators (all P < 0.001). There was a significantly higher proportion of SSc patients among subjects with more severe coronary calcification (CACS 101) compared to those with lesser severity (CACS <100) (56.5% versus 29.4%; P = 0.01). Multiple logistic regression analysis revealed SSc to be an independent determinant for a CACS 101 (OR 10.89 [95% CI 2.21-53.75], P = 0.003) together with age and LDL cholesterol level after adjustment for other cardiovascular risk factors. Among disease-specific factors, only disease duration (OR 1.14 [95% CI 1.02-1.27], P = 0.02) was independently associated with more severe coronary calcification (CACS 101). Conclusion: Our findings indicate that SSc is an independent risk factor for coronary calcification, in addition to the conventional risk factors for coronary atherosclerosis, such as age and hypertension. Copyright © 2011 by the American College of Rheumatology.
 
dc.description.natureLink_to_OA_fulltext
 
dc.identifier.citationArthritis And Rheumatism, 2011, v. 63 n. 5, p. 1387-1395 [How to Cite?]
DOI: http://dx.doi.org/10.1002/art.30283
 
dc.identifier.doihttp://dx.doi.org/10.1002/art.30283
 
dc.identifier.epage1395
 
dc.identifier.hkuros186534
 
dc.identifier.isiWOS:000290609800028
Funding AgencyGrant Number
Hong Kong Arthritis and Rheumatism Foundation
Merck Sharpe Dohme
Roche
Pfizer
Novartis
Johnson Johnson
Funding Information:

Supported by the Hong Kong Arthritis and Rheumatism Foundation Research Fund.

 
dc.identifier.issn0004-3591
2012 Impact Factor: 7.477
2012 SCImago Journal Rankings: 3.012
 
dc.identifier.issue5
 
dc.identifier.openurl
 
dc.identifier.pmid21538320
 
dc.identifier.scopuseid_2-s2.0-79955555100
 
dc.identifier.spage1387
 
dc.identifier.urihttp://hdl.handle.net/10722/135202
 
dc.identifier.volume63
 
dc.languageeng
 
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0004-3591/
 
dc.publisher.placeUnited States
 
dc.relation.ispartofArthritis and Rheumatism
 
dc.relation.referencesReferences in Scopus
 
dc.rightsArthritis & Rheumatism. Copyright © John Wiley & Sons, Inc.
 
dc.subject.meshCalcinosis - etiology - radiography
 
dc.subject.meshCarotid Artery, Common - radiography
 
dc.subject.meshCoronary Artery Disease - etiology - radiography
 
dc.subject.meshLogistic Models
 
dc.subject.meshScleroderma, Systemic - complications - radiography
 
dc.titleSystemic sclerosis is an independent risk factor for increased coronary artery calcium deposition
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong