Article: Systemic sclerosis is an independent risk factor for increased coronary artery calcium deposition
| Title | Systemic sclerosis is an independent risk factor for increased coronary artery calcium deposition | ||||||||||||||
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| Authors | Mok, MY1 Lau, CS1 Chiu, SSH1 Tso, AWK1 Lo, Y1 Law, LSC1 Mak, KF1 Wong, WS1 Khong, PL1 Lam, KSL1 | ||||||||||||||
| Issue Date | 2011 | ||||||||||||||
| Publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0004-3591/ | ||||||||||||||
| Citation | Arthritis And Rheumatism, 2011, v. 63 n. 5, p. 1387-1395 [How to Cite?] DOI: http://dx.doi.org/10.1002/art.30283 | ||||||||||||||
| Abstract | Objective: 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. | ||||||||||||||
| ISSN | 0004-3591 2011 Impact Factor: 7.866 2011 SCImago Journal Rankings: 0.871 | ||||||||||||||
| DOI | http://dx.doi.org/10.1002/art.30283 | ||||||||||||||
| ISI Accession Number ID | WOS:000290609800028
Funding Information: Supported by the Hong Kong Arthritis and Rheumatism Foundation Research Fund. | ||||||||||||||
| References | References in Scopus |
| dc.contributor.author | Mok, MY | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| dc.contributor.author | Lau, CS | ||||||||||||||
| dc.contributor.author | Chiu, SSH | ||||||||||||||
| dc.contributor.author | Tso, AWK | ||||||||||||||
| dc.contributor.author | Lo, Y | ||||||||||||||
| dc.contributor.author | Law, LSC | ||||||||||||||
| dc.contributor.author | Mak, KF | ||||||||||||||
| dc.contributor.author | Wong, WS | ||||||||||||||
| dc.contributor.author | Khong, PL | ||||||||||||||
| dc.contributor.author | Lam, KSL | ||||||||||||||
| dc.date.accessioned | 2011-07-27T01:29:56Z | ||||||||||||||
| dc.date.available | 2011-07-27T01:29:56Z | ||||||||||||||
| dc.date.issued | 2011 | ||||||||||||||
| dc.description.abstract | Objective: 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.nature | Link_to_subscribed_fulltext | ||||||||||||||
| dc.identifier.citation | Arthritis And Rheumatism, 2011, v. 63 n. 5, p. 1387-1395 [How to Cite?] DOI: http://dx.doi.org/10.1002/art.30283 | ||||||||||||||
| dc.identifier.doi | http://dx.doi.org/10.1002/art.30283 | ||||||||||||||
| dc.identifier.epage | 1395 | ||||||||||||||
| dc.identifier.hkuros | 186534 | ||||||||||||||
| dc.identifier.isi | WOS:000290609800028
Funding Information: Supported by the Hong Kong Arthritis and Rheumatism Foundation Research Fund. | ||||||||||||||
| dc.identifier.issn | 0004-3591 2011 Impact Factor: 7.866 2011 SCImago Journal Rankings: 0.871 | ||||||||||||||
| dc.identifier.issue | 5 | ||||||||||||||
| dc.identifier.openurl | ![]() | ||||||||||||||
| dc.identifier.pmid | 21538320 | ||||||||||||||
| dc.identifier.scopus | eid_2-s2.0-79955555100 | ||||||||||||||
| dc.identifier.spage | 1387 | ||||||||||||||
| dc.identifier.uri | http://hdl.handle.net/10722/135202 | ||||||||||||||
| dc.identifier.volume | 63 | ||||||||||||||
| dc.language | eng | ||||||||||||||
| dc.publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0004-3591/ | ||||||||||||||
| dc.publisher.place | United States | ||||||||||||||
| dc.relation.ispartof | Arthritis and Rheumatism | ||||||||||||||
| dc.relation.references | References in Scopus | ||||||||||||||
| dc.rights | Arthritis & Rheumatism. Copyright © John Wiley & Sons, Inc. | ||||||||||||||
| dc.subject.mesh | Calcinosis - etiology - radiography | ||||||||||||||
| dc.subject.mesh | Carotid Artery, Common - radiography | ||||||||||||||
| dc.subject.mesh | Coronary Artery Disease - etiology - radiography | ||||||||||||||
| dc.subject.mesh | Logistic Models | ||||||||||||||
| dc.subject.mesh | Scleroderma, Systemic - complications - radiography | ||||||||||||||
| dc.title | Systemic sclerosis is an independent risk factor for increased coronary artery calcium deposition | ||||||||||||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong


