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
2011 Impact Factor: 7.866
2011 SCImago Journal Rankings: 0.871
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 Field
Value
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_subscribed_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
2011 Impact Factor: 7.866
2011 SCImago Journal Rankings: 0.871
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
Author Affiliations
  1. The University of Hong Kong