A qualitative systematic review of the prevalence of coronary artery disease in systemic sclerosis

作者：Ali Hassan; Ng Kiat R; Low Andrea H L^*

来源：International Journal of Rheumatic Diseases, 2015, 18(3): 276-286.

DOI：10.1111/1756-185X.12566

• atherosclerosis
• coronary artery disease
• systematic review
• systemic sclerosis

AimsTo review existing literature on the prevalence/incidence of coronary artery disease (CAD), and secondarily highlight risk factors for CAD in systemic sclerosis (SSc).
MethodsA PubMed and Cochrane Central Register of Controlled Trials search of studies (till 30 November 2013) relating to SSc and CAD was performed, retrieving 180 titles. Inclusion criteria: studies reporting CAD prevalence/incidence in SSc based on autopsy findings, coronary artery calcium scores, coronary angiographic findings and physician/patient-reported CAD. Exclusion criteria: (i) not written in English; (ii) not concerned with human subjects; (iii) single case reports or review articles; (iv) genetic studies; and 95) other surrogate outcome measures of atherosclerosis. Quality assessment was done using the Newcastle-Ottawa score (range 0-9).
ResultsThirteen studies (Newcastle-Ottawa score 5-8) were selected. Of eight studies with controls, seven reported increased CAD prevalence (10-56%) or incidence (2.3%) compared to controls (prevalence 2-44%; incidence 1.5%). Of five studies without controls, CAD prevalence was 8-32%. Five of six studies reported that traditional cardiovascular risk factors were similar/reduced in SSc compared to controls. SSc was an independent risk factor for CAD, in addition to age (n=2), hypercholesterolaemia (n=3), male gender (n=1), hypertension and diabetes (n=1). Disease duration, renal involvement and pulmonary arterial hypertension were associated with CAD.
ConclusionsSystemic sclerosis is associated with an increased prevalence/incidence of CAD. SSc is an independent risk factor for CAD. The association of CAD with SSc-related factors requires further research. Meanwhile, patients with SSc should be screened and treated for identified traditional cardiovascular risk factors.

• 出版日期2015-3