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Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome.
J Intern Med. 2019 10; 286(4):458-468.JI

Abstract

BACKGROUND

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.

METHODS

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.

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 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.

Authors+Show Affiliations

From the, Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.Division of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.Department of Medical Sciences, Rheumatology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.From the, Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.From the, Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden.Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.Division of Rheumatology, Department of Clinical Experimental Medicine, Linköping University, Linköping, Sweden.Department of Clinical Sciences, Malmö, Rheumatology, Lund University, Malmö, Sweden.Department of Clinical Sciences, Malmö, Rheumatology, Lund University, Malmö, Sweden.From the, Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.Department of Medical Sciences, Rheumatology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31127862

Citation

Mofors, J, et al. "Concomitant Ro/SSA and La/SSB Antibodies Are Biomarkers for the Risk of Venous Thromboembolism and Cerebral Infarction in Primary Sjögren's Syndrome." Journal of Internal Medicine, vol. 286, no. 4, 2019, pp. 458-468.
Mofors J, Holmqvist M, Westermark L, et al. Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome. J Intern Med. 2019;286(4):458-468.
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. (2019). Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome. Journal of Internal Medicine, 286(4), 458-468. https://doi.org/10.1111/joim.12941
Mofors J, et al. Concomitant Ro/SSA and La/SSB Antibodies Are Biomarkers for the Risk of Venous Thromboembolism and Cerebral Infarction in Primary Sjögren's Syndrome. J Intern Med. 2019;286(4):458-468. PubMed PMID: 31127862.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome. AU - Mofors,J, AU - Holmqvist,M, AU - Westermark,L, AU - Björk,A, AU - Kvarnström,M, AU - Forsblad-d'Elia,H, AU - Magnusson Bucher,S, AU - Eriksson,P, AU - Theander,E, AU - Mandl,T, AU - Wahren-Herlenius,M, AU - Nordmark,G, Y1 - 2019/06/17/ PY - 2019/5/28/pubmed PY - 2020/5/26/medline PY - 2019/5/26/entrez KW - La/SSB KW - Primary Sjögren's syndrome KW - Ro/SSA KW - autoantibodies KW - cardiovascular disease SP - 458 EP - 468 JF - Journal of internal medicine JO - J. Intern. Med. VL - 286 IS - 4 N2 - BACKGROUND: 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. METHODS: 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. 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 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. SN - 1365-2796 UR - https://www.unboundmedicine.com/medline/citation/31127862/Concomitant_Ro/SSA_and_La/SSB_antibodies_are_biomarkers_for_the_risk_of_venous_thromboembolism_and_cerebral_infarction_in_primary_Sjögren's_syndrome_ L2 - https://doi.org/10.1111/joim.12941 DB - PRIME DP - Unbound Medicine ER -