201. The risk of major adverse cardiovascular events in patients with systemic sclerosis: a nationwide, population-based cohort study.
- Author
-
Yen TH, Chen YW, Hsieh TY, Chen YM, Huang WN, Chen YH, and Chen HH
- Subjects
- Humans, Male, Female, Middle Aged, Taiwan epidemiology, Incidence, Aged, Adult, Risk Factors, Cohort Studies, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Proportional Hazards Models, Propensity Score, Peripheral Arterial Disease epidemiology, Scleroderma, Systemic epidemiology, Scleroderma, Systemic complications, Myocardial Infarction epidemiology, Myocardial Infarction etiology
- Abstract
Objective: The objective of this study was to assess the incidence and risk factors of major adverse cardiovascular events (MACEs) in patients with systemic sclerosis (SSc)., Methods: We conducted a nationwide, population-based, cohort study using Taiwan's National Health Insurance Research Database. We performed propensity score matching (PSM) using a 1:2 ratio, resulting in inclusion of 1379 patients with SSc and 2758 non-SSc individuals in the analysis. We assessed the association between SSc and MACEs, using the multivariable Cox proportional hazard regression model with adjustment of time-dependent covariates, and investigated risk factors for MACEs in patients with SSc, shown as adjusted hazard ratios (aHRs) with 95% CIs., Results: SSc was not significantly associated with the risk of MACEs (aHR 1.04; 95% CI 0.77-1.42). Nevertheless, SSc was associated with increased risk of myocardial infarction [incidence rate ratio (IRR) 1.76; 95% CI 1.08-2.86] and peripheral arterial occlusion disease (IRR 3.67; 95% CI 2.84-4.74) but not of ischaemic stroke (IRR 0.89; 95% CI 0.61-1.29). Factors independently associated with MACEs in SSc patients included age (aHR 1.02), male gender (aHR 2.01), living in a suburban area (aHR 2.09), living in a rural area (aHR 3.00), valvular heart disease (aHR 4.26), RA (aHR 2.14), use of clopidogrel (aHR 26.65), and use of aspirin (aHR 5.31)., Conclusions: The risk of MACEs was not significantly increased in Taiwanese patients with SSc, and our investigation effectively identified the factors independently associated with MACEs in SSc patients. Additionally, patients with SSc exhibited higher risks of myocardial infarction and peripheral arterial occlusion disease but not of ischaemic stroke., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2024
- Full Text
- View/download PDF