Abstract 18156: Cardiac and Macrovascular Manifestation of Systemic Sclerosis (Scleroderma) - A Danish Nationwide Cohort Study

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Abstract

Introduction: While many microvascular and cardiac manifestations of systemic sclerosis (SSc) are well-described, other macrovascular and cardiac complications are less well studied. We investigated the prevalence and incidence of various cardiovascular diseases in a large cohort of patients with SSc compared with a matched population.

Hypothesis: We assessed the hypothesis that the risk of a large spectrum of cardiac and macrovascular complications in SSc is increased as compared to age and sex-matched controls.

Methods: From the Danish nationwide administrative registries, all patients >18 years of age with first-diagnosis SSc in 1996-2012 were identified and matched on age and sex (1:5) with controls from the general population. Prevalence of cardiovascular diseases at the time of the SSc diagnosis and incidences during follow-up (maximally until 2012) was assessed by hospitalization discharge diagnoses.

Results: Within a study population of 2,704 patients with SSc (77% women, mean age at diagnosis 55 ± standard deviation 17 years) and 13,520 controls, an increased prevalence at time of diagnosis and an increased incidence during follow-up of well-known cardiovascular complications (pulmonary arterial hypertension/cor pulmonale, pericarditis, chronic kidney disease, arrhythmias) and less often studied complications (peripheral artery disease, valvulopathy, myocardial infarction, stroke) was observed when compared with the reference population; Figure 1.

Conclusions: In conclusion, we confirm the increased risk of several well-known SSc cardiac complications. Furthermore, a higher risk for less often described cardiac and macrovascular complications was also observed with a further need for elucidation of the pathogenesis.

Footnote: * Defined as atherosclerosis in peripheral artery or aorta.

Relative risks are expressed as odds ratios for prevalent diseases and hazard ratios for incident diseases.

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