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- Title
Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome.
- Authors
Mofors, J.; Holmqvist, M.; Westermark, L.; Björk, A.; Kvarnström, M.; Forsblad‐d'Elia, H.; Magnusson Bucher, S.; Eriksson, P.; Theander, E.; Mandl, T.; Wahren‐Herlenius, M.; Nordmark, G.; Forsblad-d'Elia, H; Wahren-Herlenius, M
- Abstract
<bold>Background: </bold>To assess the risk of incident cardiovascular disease in patients with primary Sjögren's syndrome, overall and stratified by Ro/SSA and La/SSB autoantibody status.<bold>Methods: </bold>A cohort of patients with primary Sjögren's syndrome in Sweden (n = 960) and matched controls from the general population (n = 9035) were included, and data extracted from the National Patient Register to identify events of myocardial infarction, cerebral infarction and venous thromboembolism. Hazard ratios were estimated using cox proportional hazard regressions.<bold>Results: </bold>During a median follow-up of 9.5 years, the overall hazard ratio (HR) was 1.6 (95% CI 1.2-2.1) for myocardial infarction, 1.2 (95% CI 0.9-1.7) for cerebral infarction and 2.1 (95% CI 1.6-2.9) for venous thromboembolism. Patients positive for both Ro/SSA and La/SSB autoantibodies had a substantially higher risk of cerebral infarction (HR 1.7, 95% CI 1.0-2.9) and venous thromboembolism (HR 3.1, 95% CI 1.9-4.8) than the general population. These risks were not significantly increased in Ro/SSA- and La/SSB-negative patients. Among autoantibody-positive patients, the highest HR of cerebral infarction was seen after ≥10 years disease duration (HR 2.8, 95% CI 1.4-5.4), while the HR for venous thromboembolism was highest 0-5 years after disease diagnosis (HR 4.7, 95% CI 2.3-9.3) and remained high throughout disease duration.<bold>Conclusions: </bold>Primary Sjögren's syndrome is associated with a markedly increased risk of cardiovascular disease and the presence of Ro/SSA and La/SSB autoantibodies identify the subgroup of patients carrying the highest risk. These findings suggest that monitoring and prevention of cardiovascular disease in this patient group should be considered.
- Subjects
SWEDEN; THROMBOEMBOLISM; MYOCARDIAL infarction; SYNDROMES; IMMUNOGLOBULINS; CARDIOVASCULAR diseases; HEART block
- Publication
Journal of Internal Medicine, 2019, Vol 286, Issue 4, p458
- ISSN
0954-6820
- Publication type
journal article
- DOI
10.1111/joim.12941