About 10% of the populace in high income regions like Europe and america has been identified as having one or multiple autoimmune disorders. Examples are arthritis rheumatoid, psoriasis, systemic sclerosis, lupus erythematosus and type I diabetes. Although earlier research has suggested associations between a few of these disorders and an increased risk of coronary disease, these studies were often too small and limited by selected autoimmune or selected cardiovascular conditions to draw conclusive evidence on the need of coronary disease prevention among patients with autoimmune disease, as yet.
At the annual congress of the European Society of Cardiology, held this weekend in Barcelona, a global research team led by KU Leuven presented the results of an intensive epidemiological investigation into possible links between 19 of the very most common autoimmune disorders and coronary disease. The outcomes of the analysis show that patients with autoimmune disease have a substantially higher risk (between 1.4 and 3.6 times based on which autoimmune condition) of developing coronary disease than people lacking any autoimmune disorder. This excess risk is related to that of type 2 diabetes, a well-known risk factor for coronary disease. The study shows for the very first time that cardiovascular risks affect autoimmune disease as several disorders, instead of selected disorders individually.
The complete coronary disease spectrum
In the study paper, which is published in The Lancet, the authors show that the band of 19 autoimmune disorders they will have studied makes up about about 6% of cardiovascular events. Importantly, excess cardiovascular risk was visible over the whole coronary disease spectrum, beyond classical cardiovascular system disease, including infection-related heart disorders, heart inflammation, and also thromboembolic and degenerative heart disorders, suggesting the implications of autoimmunity on cardiovascular health will tend to be much broader than originally thought.
Furthermore, the surplus risk had not been explained by traditional cardiovascular risk factors such as for example age, sex, socioeconomic status, blood circulation pressure, BMI, smoking, cholesterol and type 2 diabetes. Another noteworthy finding: the surplus risk is specially high among patients with autoimmune disorders under 55 years and shows that autoimmune disease is specially important in causing premature coronary disease, with the potential to bring about a disproportionate lack of life years and disability.
The analysis was predicated on electronic health records from the United Kingdom’s Clinical Practice Research Datalink (CPRD), an extremely large database of anonymized patient data from about one-fifth of the existing U.K. population. Among 22 million patient records, the researchers assembled a cohort of patients newly identified as having the 19 autoimmune disorders. Then they viewed the incidence of 12 cardiovascular outcomesan unprecedented granularity that has been permitted by the large size of the datasetin the next years, plus they compared it to a matched control group.
The chance of developing coronary disease for patients with a number of autoimmune disorders was normally 1.56 times greater than in those without autoimmune disease. In addition they found that the surplus risk rose with the amount of different autoimmune disorders in individual patients. On the list of disorders with the best excess risk were systemic sclerosis, Addison’s disease, lupus and type I diabetes.
Dependence on targeted prevention measures
The outcomes show that action is necessary, says Nathalie Conrad, lead writer of the analysis. “We note that the surplus risk is related to that of type 2 diabetes. But although we’ve specific measures directed at diabetes patients to lessen their threat of developing coronary disease (with regards to prevention and follow-up), we haven’t any similar measures for patients with autoimmune disorders.” Conrad mentions the European Society of Cardiology guidelines on preventing cardiovascular diseases, which don’t yet mention autoimmunity as a cardiovascular risk factor (the rules only mention some specific disorders, like lupus) nor do they list any specific prevention measures for patients with autoimmune disease.
Conrad hopes the analysis will raise awareness among patients with autoimmune disease and clinicians mixed up in care of the patients, that may include a variety of specialties such as for example cardiologists, rheumatologists, or general practitioners. “We have to develop targeted prevention measures for these patients. And we have to do further research that helps us realize why patients having an autoimmune disorder develop more cardiovascular diseases than others, and how exactly we can prevent this from happening.”
Talking about the pathophysiology, the underlying mechanisms remain poorly understood. Conrad says, “The overall hypothesis is that chronic and systemic inflammation, that is a common denominator in autoimmune disorders, can trigger a variety of coronary disease. Ramifications of autoimmune disease on connective tissues, small vessels, and cardiomyocytes, and perhaps a few of the treatments popular to take care of autoimmunity may also be likely to donate to patients’ cardiovascular risk. This really must be investigated thoroughly.”
Also area of the team was cardiologist John McMurray (University of Glasgow, U.K.). He says, “This population-based study shows that a much broader selection of autoimmune disorders than previously recognized are of a selection of different cardiovascular problems.” He also mentions a possible solution for a while: “A few of these problems are potentially preventable using easily available treatments such as for example statins.”
More info: Autoimmune diseases and cardiovascular risk: a populationbased study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the united kingdom, The Lancet (2022). DOI: 10.1016/S0140-6736(22)01349-6
Citation: Population-based study: Autoimmune disorders increase threat of coronary disease (2022, August 27) retrieved 27 August 2022 from https://medicalxpress.com/news/2022-08-population-based-autoimmune-disorders-cardiovascular-disease.html
This document is at the mercy of copyright. Aside from any fair dealing for the intended purpose of private study or research, no part could be reproduced minus the written permission. This content is provided for information purposes only.