medwireNews: Individuals with certain immune-mediated inflammatory diseases (IMIDs) are at increased risk for premature coronary artery disease (CAD), show population-based study data from Taiwan.
Specifically, systemic sclerosis (SSc), systemic lupus erythematosus (SLE), systemic vasculitis, and primary Sjogren’s syndrome “should be regarded as independent risk factors in respect of developing premature CAD,” say Meng-Yu Weng and co-investigators from National Cheng Kung University in Tainan.
Using data from Taiwan’s National Health Insurance program, the researchers identified 58,862 individuals aged 18 years and older who were diagnosed with an IMID between 2007 and 2016 and matched them to 1 million controls without IMID.
Patients with IMIDs included those with rheumatoid arthritis (RA; n=26,820), primary Sjogren’s syndrome (n=17,530), SLE (n=10,014), idiopathic inflammatory myositis (n=1488), SSc (n=1373), Behcet’s disease (n=1161), and systemic vasculitis (n=476).
During a mean 5.3 years of follow-up, the overall CAD-related hospitalization rate was 3.6% among the individuals with IMIDs and 2.0% among controls, corresponding to a 1.30-fold increased risk in the IMID group, after adjustment for traditional risk factors and medication use.
For the individual IMIDs, the CAD-related hospitalization rates were 6.1% among patients with SSc, 4.6% among those with systemic vasculitis, 4.3% for RA, 4.0% for idiopathic inflammatory myositis, 3.0% among those with Sjogren’s syndrome, 2.8% for SLE, and 1.6% among the individuals with Behcet’s disease.
In adjusted analyses, Weng and team found that individuals with SSc were almost twice as likely to develop CAD as those without SSc, at a hazard ratio (HR) of 1.96. Individuals with SLE, idiopathic inflammatory myositis, Sjogren’s syndrome, and RA, also had significantly increased risks for CAD, at HRs of 1.78, 1.63, 1.25, and 1.21, respectively.
Furthermore, the overall risk for hospitalization for premature CAD, defined as that occurring before the ages of 45 years in men and 50 years in women, was a significant 1.71-fold higher in the participants with IMIDs relative to controls, occurring at rates of 1.3% and 0.5%, respectively, during follow-up.
The HR for premature CAD hospitalization was a significant 3.18 for individuals with SSC versus controls, 2.85 for those with SLE, 2.27 for those with systemic vasculitis, and 1.43 for people with primary Sjogren’s syndrome. Individuals with RA, idiopathic inflammatory myositis, or Behcet’s disease did not have significantly increased risks for premature CAD.
Writing in RMD Open, Weng and co-authors say their findings “indicate an age-dependent pattern of CAD risk among patients with certain IMIDs.”
They add: “Premature CAD carries a poor long-term prognosis so it is paramount that we understand and explain unique risk factors to prevent CAD events in younger populations.”
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