Sjögren's syndrome linked to increased cardiovascular comorbidity
Primary Sjögren’s syndrome is associated with increased cardiovascular comorbidities, according to data published in Arthritis Care & Research.
“Patients with chronic autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus are at increased risk of cardiovascular disease, largely because of the systemic inflammation,” Aurelie Beltai, MBBS, of the University of Montpellier, France, and colleagues wrote. “In RA, the cardiovascular disease is the main cause of death. [Primary Sjögren’s syndrome] publications show different estimations of the incidence of cardiovascular complications. This heterogeneity of data led us to conduct a systematic review of this topic.”
To analyze the association between primary Sjögren’s syndrome and cardiovascular morbidity and mortality, Beltai and colleagues conducted a meta-analysis of studies that estimated cardiovascular events with primary Sjögren’s syndrome compared with control groups. The researchers performed a systematic review of articles in Medline and the Cochrane library, as well as abstracts from U.S. and European meetings, focusing on randomized, controlled studies.
Out of 484 articles and abstracts identified, the researchers included 14 in their final analysis. These 14 studies included 67,124 patients with primary Sjögren’s syndrome. Beltai and colleagues recorded relative risk values for cardiovascular morbidity and mortality associated with primary Sjögren’s syndrome in a metaanalysis with a randomeffects model by using Review Manager.
According to the researchers, the risk for coronary morbidity was significantly increased among the primary Sjögren’s syndrome populations (RR = 1.34; 95% CI, 1.061.38), compared with those in control groups. Patients with primary Sjögren’s syndrome also demonstrated significantly increased risks for cerebrovascular morbidity (RR = 1.46, 95%; CI, 1.431.49), heart failure rate (OR = 2.54; 95% CI, 1.3-4.97), and thromboembolic morbidity (RR = 1.78; 95% CI, 1.41-2.25). However, there was with no statistically significant increased risk for cardiovascular mortality (RR = 1.48; 95% CI, 0.772.85) among patients with primary Sjögren’s syndrome.
“This meta-analysis confirms that patients with [primary Sjögren’s syndrome] show increased risk of cardiovascular disease as compared with the general population,” Beltai and colleagues wrote. “Mechanisms underlying the increased risk of cardiovascular events in [primary Sjögren’s syndrome] are not exactly elucidated: The respective weight of classical risk factors is not clearly determined. ... However, rheumatologists should be aware of this increased risk in order to propose screening for cardiovascular comorbidities and specific preventive interventions for patients with [primary Sjögren’s syndrome].” – by Jason Laday
Disclosure: Beltai reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.