A 20-year follow-up study identifies risk factors of CVD in primary Sjogren’s syndrome patients

A 20-year follow-up study conducted by a team of Spanish researchers showed that patients with primary Sjogren’s syndrome (pSS) having extraglandular involvement had a higher prevalence of arterial hypertension, dyslipidemia, hyperuricemia, and coronary artery disease. The study published in the journal Clinical Rheumatology also showed that individuals with anti-Ro/SSA and anti-La/SSB seropositivity exhibited a higher prevalence of cardiac rhythm abnormalities, hyperuricemia, venous thrombosis, coronary artery disease, and cerebrovascular disease.  

Dr. Santos and his colleagues conducted a retrospective study to analyze the clinical significance and risk factors for cardiovascular disease (CVD) in pSS patients. Out of 102 pSS patients, 36% had at least one CV risk factor. Arterial hypertension, dyslipidemia, diabetes, obesity, and hyperuricemia were diagnosed in 59%, 27%, 15%, 22%, and 18% of patients, respectively. A history of arrhythmia was discovered in 25%, conduction abnormalities in 10%, arterial peripheral vascular disease in 7%, venous thrombosis in 10%, coronary artery disease in 24%, and cerebrovascular disease in 22% of the patients. After adjusting for age, sex, disease duration, and significant variables in the univariate analysis, patients with extraglandular involvement had a higher prevalence of arterial hypertension (P =0.04), dyslipidemia (P =0.003), LDL mean values (P =0.038), hyperuricemia (P =0.03), and coronary artery disease (P =0.01). The risk of hyperuricemia (P =0.01), arrhythmia (P =0.01), coronary artery disease (P =0.02), cerebrovascular disease (P =0.02), and venous thrombosis (P =0.03) was significantly higher in patients with Ro/SSA and La/SSB autoantibodies. Extraglandular involvement was linked to greater probabilities of cardiovascular risk factors in the multivariate logistic regression analysis (P =0.02). 

Another recent study conducted by Dr. Zippel and his team has also analyzed the risk factors for CVD in 312 pSS patients. The usual risk factors for CVD, such as hypertension, hypercholesterinemia, and diabetes (P <0.05) were present in 19.6% of the pSS patients, along with vasculitis (P =0.033) and Raynaud’s phenomenon (P =0.018) as pSS symptoms. Results reported connections with higher ESSDAI (P =0.039) and EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI) (P =0.048) in patients with ischemic episodes (28/312, 9%), particularly cerebrovascular disease (n=12/28, 42.9%). The age of the initial cerebrovascular episode ranged from 48.9 to 69.6 years. Raynaud’s phenomenon (P =0.007), hypertension (P <0.001), hypercholesterolemia (P < 0.001), male gender (P =0.009), CNS involvement (P =0.048), and multivariate analysis also confirmed these factors as independent CVD predictors. 

Understanding and addressing the cardiovascular risk factors in pSS patients can significantly improve patient outcomes. Clinicians should remain vigilant in assessing and managing these risk factors to ensure the best possible care for their patients. Continued research efforts will be instrumental in refining risk assessment models and optimizing preventive strategies for cardiovascular complications in individuals with pSS. 

References 

  1. Santos CS, Salgueiro RR, Morales CM, Castro CA, Alvarez ED. Risk factors for cardiovascular disease in primary Sjögren’s syndrome (pSS): a 20-year follow-up study. Clinical Rheumatology. 2023:1-1.
  2. Zippel CL, Beider S, Kramer E, Konen FF, Seeliger T, Skripuletz T, et al. POS1449 Cardiovascular disease in primary Sjogren Syndrome. 2023:1078-1078 
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