Sun Guoli, Fosbøl Emil L, Yafasova Adelina, Faurschou Mikkel, Lindhardsen Jesper, Torp-Pedersen Christian, Køber Lars, Butt Jawad H
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
J Intern Med. 2023 Apr;293(4):457-469. doi: 10.1111/joim.13595. Epub 2022 Dec 11.
Data on long-term cardiovascular outcomes in primary Sjögren's syndrome (PSS) are scarce.
We aim to investigate the long-term rate of incident heart failure (HF) and other adverse cardiovascular endpoints in patients with PSS compared with the general population and to investigate mortality in individuals with incident HF with or without a history of PSS.
Using Danish nationwide registries, PSS patients (diagnosed 1996-2018) without a history of other autoimmune diseases were each matched with four individuals from the general population by sex, age, and comorbidities. Multivariable Cox regression was used to estimate the rate of cardiovascular outcomes. In addition, the rate of death from any cause was compared between PSS patients with incident HF and four age- and sex-matched HF patients without PSS.
In total, 5092 patients with newly diagnosed PSS were matched with 20,368 individuals from the general population (median age 57 years, 87.3% women, median follow-up 7.4 years). The cumulative incidence of HF at 10 years was 4.0% for PSS patients and 2.8% for matched individuals. After adjustment, patients with PSS had a higher associated rate of incident HF (hazard ratios [HR] 1.42 [95% CI, 1.20-1.68]) and other cardiovascular outcomes, compared with the background population. PSS patients with incident HF had a similar rate of death from all-cause mortality compared with HF patients without PSS (HR 0.94 [0.74-1.19]).
Patients with PSS had a higher associated rate of incident HF and other cardiovascular outcomes compared with the general population. In individuals with incident HF, a history of PSS was not associated with increased mortality.
原发性干燥综合征（PSS）长期心血管结局的数据匮乏。
我们旨在调查PSS患者与普通人群相比发生心力衰竭（HF）及其他不良心血管终点的长期发生率，并调查发生HF的患者（无论有无PSS病史）的死亡率。
利用丹麦全国性登记系统，将无其他自身免疫性疾病病史的PSS患者（诊断时间为1996 - 2018年）按性别、年龄和合并症与4名普通人群个体进行匹配。采用多变量Cox回归估计心血管结局的发生率。此外，比较发生HF的PSS患者与4名年龄和性别匹配的无PSS的HF患者的全因死亡率。
总共5092例新诊断的PSS患者与20368名普通人群个体相匹配（中位年龄57岁，87.3%为女性，中位随访7.4年）。PSS患者10年HF累积发生率为4.0%，匹配个体为2.8%。调整后，与普通人群相比，PSS患者发生HF及其他心血管结局的相关发生率更高（风险比[HR] 1.42 [95% CI，1.20 - 1.68]）。发生HF的PSS患者与无PSS的HF患者的全因死亡率相似（HR 0.94 [0.74 - 1.19]）。
与普通人群相比，PSS患者发生HF及其他心血管结局的相关发生率更高。在发生HF的个体中，PSS病史与死亡率增加无关。
