دورية أكاديمية
أعرض في EDS

Association of Autoimmune Diseases With Coronary Atherosclerosis Severity and Ischemic Events.

التفاصيل البيبلوغرافية
العنوان: Association of Autoimmune Diseases With Coronary Atherosclerosis Severity and Ischemic Events.
المؤلفون: Mortensen MB; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: martin.bodtker.mortensen@clin.au.dk., Jensen JM; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Rønnow Sand NP; Department of Cardiology, University Hospital of Southwest Jutland and Institute of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark., Kragholm K; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark., Blaha MJ; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Grove EL; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Sørensen HT; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark., Olesen K; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Maeng M; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Løgstrup B; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Busk M; Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark., Hauge EM; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark., Navar AM; Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Bøtker HE; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Nørgaard BL; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
المصدر: Journal of the American College of Cardiology [J Am Coll Cardiol] 2024 Jun 25; Vol. 83 (25), pp. 2643-2654.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print Cited Medium: Internet ISSN: 1558-3597 (Electronic) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983-
مواضيع طبية MeSH: Coronary Artery Disease*/epidemiology , Autoimmune Diseases*/epidemiology , Autoimmune Diseases*/complications , Severity of Illness Index* , Registries*, Humans ; Male ; Female ; Middle Aged ; Aged ; Denmark/epidemiology ; Computed Tomography Angiography ; Coronary Angiography ; Risk Factors ; Myocardial Ischemia/epidemiology ; Follow-Up Studies
مستخلص: Background: Some autoimmune diseases carry elevated risk for atherosclerotic cardiovascular disease (ASCVD), yet the underlying mechanism and the influence of traditional risk factors remain unclear.
Objectives: This study sought to determine whether autoimmune diseases independently correlate with coronary atherosclerosis and ASCVD risk and whether traditional cardiovascular risk factors modulate the risk.
Methods: The study included 85,512 patients from the Western Denmark Heart Registry undergoing coronary computed tomography angiography. A diagnosis of 1 of 18 autoimmune diseases was assessed. Adjusted OR (aOR) for any plaque, any coronary artery calcification (CAC), CAC of >90th percentile, and obstructive coronary artery disease as well as adjusted HR (aHR) for ASCVD were calculated.
Results: During 5.3 years (Q1-Q3: 2.8-8.2 years) of follow-up, 3,832 ASCVD events occurred. A total of 4,064 patients had a diagnosis of autoimmune disease, which was associated with both presence of any plaque (aOR: 1.29; 95% CI: 1.20-1.40), any CAC (aOR: 1.28; 95% CI: 1.19-1.37), and severe CAC of >90th percentile (aOR: 1.53; 95% CI: 1.39-1.68), but not with having obstructive coronary artery disease (aOR: 1.04; 95% CI: 0.91-1.17). Patients with autoimmune diseases had a 46% higher risk (aHR: 1.46; 95% CI: 1.29-1.65) for ASCVD. Traditional cardiovascular risk factors were strongly associated with future ASCVD events, and a favorable cardiovascular risk factor profile in autoimmune patients was associated with ∼54% lower risk compared to patients with presence of risk factors (aHR: 0.46; 95% CI: 0.27-0.81).
Conclusions: Autoimmune diseases were independently associated with higher burden of coronary atherosclerosis and higher risk for future ASCVD events, with risk accentuated by traditional cardiovascular risk factors. These findings suggest that autoimmune diseases increase risk through accelerated atherogenesis and that cardiovascular risk factor control is key for improving prognosis in patients with autoimmune diseases.
Competing Interests: Funding Support and Author Disclosures This study was funded by Aarhus University Hospital. The funding source had no influence on study design, conduct or reporting. Dr Blaha has received grants from the National Institutes of Health, U.S. Food and Drug Administration, American Heart Association, and Aetna Foundation; has received grants and personal fees from Amgen; and has received personal fees from Sanofi, Regeneron, Novartis, Bayer, and Novo Nordisk outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: atherosclerosis; autoimmune disease; computed tomography angiography; coronary artery disease
تواريخ الأحداث: Date Created: 20240619 Date Completed: 20240619 Latest Revision: 20240619
رمز التحديث: 20240620
DOI: 10.1016/j.jacc.2024.04.030
PMID: 38897674
قاعدة البيانات: MEDLINE
الوصف
تدمد:1558-3597
DOI:10.1016/j.jacc.2024.04.030