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A qualitative systematic review of the prevalence of coronary artery disease in systemic sclerosis
Author(s) -
Ali Hassan,
Ng Kiat R.,
Low Andrea H. L.
Publication year - 2015
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12566
Subject(s) - medicine , coronary artery disease , incidence (geometry) , diabetes mellitus , risk factor , cardiology , endocrinology , physics , optics
Aims To review existing literature on the prevalence/incidence of coronary artery disease ( CAD ), and secondarily highlight risk factors for CAD in systemic sclerosis ( SS c). Methods A PubMed and Cochrane Central Register of Controlled Trials search of studies (till 30 November 2013) relating to SS c and CAD was performed, retrieving 180 titles. Inclusion criteria: studies reporting CAD prevalence/incidence in SS c 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). Results Thirteen 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 SS c compared to controls. SS c 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 . Conclusions Systemic sclerosis is associated with an increased prevalence/incidence of CAD . SS c is an independent risk factor for CAD . The association of CAD with SS c‐related factors requires further research. Meanwhile, patients with SS c should be screened and treated for identified traditional cardiovascular risk factors.