Abstract 18049: Systemic Sclerosis and Risk of Myocardial Infarction: A Nationwide Study

Abstract

Background Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by organ fibrosis and vasculopathy. However, the association between SSc and acute myocardial infarction (AMI) remains unclear. Therefore, we investigated whether SSc increase the risk of AMI in a large, nationwide cohort study. Methods From the Registry of Catastrophic Illness in Taiwan, we obtained data for 1280 patients with a diagnosis of SSc from 1997 to 2006. We also obtained data for 10 times of age-, gender-, comorbidities-, and enrolled date-matched controls per SSc patient from the Longitudinal Health Insurance 2000. All study subjects were followed up from the date of enrollment until they developed AMI, death or to the end of 2006, whichever was earlier. We used Cox’s regression model with adjustment for age, gender and comorbid disorders was used to assess the independent factor in determining the risk of developing AMI. Results We identified 1,238 SSc patients and 12,380 controls. Among these 188 (28 SSc patients and 160 controls) had developed AMI during the median 4.7 years (0.1-10.0 years) follow-up period. Patients with SSc had significant higher incidence of AMI when compared to controls (5.4/1000 person-year vs. 2.7/1000 person-year). After multivariate analysis, SSc was an independent factor associated with increased risk of AMI (HR; 2.72, 95% CI, 1.72-4.23). Additionally, the medication usually being prescribed among SSc patients did not alter the risk of further AMI. Conclusion We conclude that SSc is independently associated with risk of AMI development.