Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

A gender gap in primary and secondary heart dysfunctions in systemic sclerosis: a EUSTAR prospective study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Mycobacterium intracellulare Infection Mimicking Progression of Scleroderma

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Digital ulcers predict a worse disease course in patients with systemic sclerosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Incidences and Risk Factors of Organ Manifestations in the Early Course of Systemic Sclerosis: A Longitudinal EUSTAR Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. A comparison of anti-nuclear antibody quantification using automated enzyme immunoassays and immunofluorescence assays

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Muriel Elhai
  • Jérôme Avouac
  • Ulrich A Walker
  • Marco Matucci-Cerinic
  • Gabriela Riemekasten
  • Paolo Airò
  • Eric Hachulla
  • Gabriele Valentini
  • Patricia E Carreira
  • Franco Cozzi
  • Alexandra Balbir Gurman
  • Yolanda Braun-Moscovici
  • Nemanja Damjanov
  • Lidia P Ananieva
  • Raffaella Scorza
  • Sergio Jimenez
  • Joanna Busquets
  • Mengtao Li
  • Ulf Müller-Ladner
  • André Kahan
  • Oliver Distler
  • Yannick Allanore
  • EUSTAR co-authors (Merete Engelhart, member)
  • Merete Engelhart (Medlem af forfattergruppering)
Vis graf over relationer

OBJECTIVES: In agreement with other autoimmune diseases, systemic sclerosis (SSc) is associated with a strong sex bias. However, unlike lupus, the effects of sex on disease phenotype and prognosis are poorly known. Therefore, we aimed to determine sex effects on outcomes.

METHOD: We performed a prospective observational study using the latest 2013 data extract from the EULAR scleroderma trials and research (EUSTAR) cohort. We looked at (i) sex influence on disease characteristics at baseline and (ii) then focused on patients with at least 2 years of follow-up to estimate the effects of sex on disease progression and survival.

RESULTS: 9182 patients with SSc were available (1321 men) for the baseline analyses. In multivariate analysis, male sex was independently associated with a higher risk of diffuse cutaneous subtype (OR: 1.68, (1.45 to 1.94); p<0.001), a higher frequency of digital ulcers (OR: 1.28 (1.11 to 1.47); p<0.001) and pulmonary hypertension (OR: 3.01 (1.47 to 6.20); p<0.003). In the longitudinal analysis (n=4499), after a mean follow-up of 4.9 (±2.7) years, male sex was predictive of new onset of pulmonary hypertension (HR: 2.66 (1.32 to 5.36); p=0.006) and heart failure (HR: 2.22 (1.06 to 4.63); p=0.035). 908 deaths were recorded, male sex predicted deaths of all origins (HR: 1.48 (1.19 to 1.84); p<0.001), but did not significantly account for SSc-related deaths.

CONCLUSIONS: Although more common in women, SSc appears as strikingly more severe in men. Our results obtained through the largest worldwide database demonstrate a higher risk of severe cardiovascular involvement in men. These results raise the point of including sex in the management and the decision-making process.

OriginalsprogEngelsk
TidsskriftAnnals of the Rheumatic Diseases
Vol/bind75
Udgave nummer1
Sider (fra-til)163-9
ISSN0003-4967
DOI
StatusUdgivet - 2016

ID: 45124254