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Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjogren's syndrome
Karolinska Univ Hosp, Karolinska Inst, Dept Med, Div Rheumatol, Stockholm, Sweden.
Karolinska Inst, Dept Med, Div Clin Epidemiol, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Rheumatology.
Karolinska Univ Hosp, Karolinska Inst, Dept Med, Div Rheumatol, Stockholm, Sweden.
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2019 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 286, no 4, p. 458-468Article in journal (Refereed) Published
Abstract [en]

Background To assess the risk of incident cardiovascular disease in patients with primary Sjogren's syndrome, overall and stratified by Ro/SSA and La/SSB autoantibody status. Methods A cohort of patients with primary Sjogren'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. Results 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. Conclusions Primary Sjogren'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.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 286, no 4, p. 458-468
Keywords [en]
autoantibodies, cardiovascular disease, La, SSB, Primary Sjogren's syndrome, Ro, SSA
National Category
Cardiac and Cardiovascular Systems Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:uu:diva-395731DOI: 10.1111/joim.12941ISI: 000487721800007PubMedID: 31127862OAI: oai:DiVA.org:uu-395731DiVA, id: diva2:1365136
Funder
Swedish Heart Lung FoundationSwedish Research CouncilAvailable from: 2019-10-23 Created: 2019-10-23 Last updated: 2019-10-23Bibliographically approved

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