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Increased Risk of Cardiovascular Complications in People with SARDs
ARC_FR_Research_CardioComplication_425x296
Scientific Study Title:
Risk of Heart Attack, Stroke and Venous Thromboembolism in People with Systemic Autoimmune Rheumatic Diseases (SARDs)
Start Date:
  • 2013
End Date:
  • T.B.D.
Research Category
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Why do this research?

Systemic autoimmune rheumatic diseases (SARDs) are a group of rare diseases in which a person’s immune system malfunctions and attacks its own tissues. SARDs include systemic lupus erythematosus (SLE), scleroderma, Sjögren’s syndrome, polymyositis (PM), dermatomyositis (DM), and the systemic vasculitides (granulomatosis with polyangiitis, formerly known as Wegener’s, giant cell arteritis [GCA], polyarteritis nodosa, Takayasu’s arteritis).

Limited research has been done on the risk of cardiovascular complications, which include heart attack, stroke and venous thromboembolism (blood clots in the legs and/or lungs), in people with SARDs. Of those studies that have been done, most are from people seen in specialized clinics where they see the sickest patients; therefore, the exact risk of cardiovascular complications for people with SARDs from the general population is unknown.

The goal of our study is to determine if people with SARDs have an increased risk of developing complications like heart attack, stroke or venous thromboembolism. Changes in risk of developing these complications over time are also being explored.

What will be done?

Using anonymized administrative health data from the British Columbia Ministry of Health, we determined rates of cardiovascular complications in people with all types of SARDs.

What did we find?

Patients with SARDs have a significantly increased risk of venous thromboembolism. The risk is increased 7-fold in patients with DM and PM, 2.5-fold in patients with GCA, 3-fold in patients with SLE, and 3.5-fold in patients with scleroderma, compared with the general population. Also, within one year of being diagnosed, patients with SLE have a 13.5 times increased risk of developing venous thromboembolism, while patients with scleroderma have a 12 times increased risk, compared with the general population.

Patients with SARDs also have a significantly increased risk of having a heart attack or a stroke. The risk of a heart attack is increased 2-fold in patients with GCA, 3.5-fold in patients with scleroderma, and 4-fold in patients with DM and PM, compared with the general population. In patients with GCA, the risk of a stroke was also 2 times greater than the general population’s risk; those with scleroderma have a 2.4 times greater risk of stroke. Regardless of the SARD, the risk of having a heart attack or stroke was significantly higher within one year of being diagnosed with a SARD.

These results point to the need for increased screening and monitoring for cardiovascular complications in patients with SARDs, particularly within the first year of diagnosis. Early diagnosis of SARDS followed by rapid treatment is needed to decrease inflammation, which is a risk factor for developing cardiovascular complications.

What are the next steps?

From the SARDs patients included in our previous analyses, we plan to identify those individuals at highest risk of developing cardiovascular complications. We will then determine what the risk factors for cardiovascular complications are amongst these SARDs patients.

The Research Team

Principal Investigator

  • J. Antonio Avina-Zubieta, MD, MSc, PhD, FRCPC, Senior Scientist, Rheumatology, Arthritis Research Canada (University of British Columbia)

Co-Investigators

  • Hyon Choi, MD, DrPH, FRCPC, Research Scientist, Rheumatology, Arthritis Research Canada (Harvard Medical School)

Research Staff

  • Lynn Nowoselski, Research Assistant, ARC
  • Lindsay Belvedere, Research Assistant, ARC
  • Kathryn Reimer, Research Assistant, ARC
  • Eric C Sayre, PhD, Statistician, ARC

Who Funded This Research?

Canadian Institutes of Health Research, Michael Smith Foundation for Health Research, British Columbia Lupus Society

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