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Meta-Analysis
. 2024 Mar 18;14(1):6445.
doi: 10.1038/s41598-024-57275-9.

Association between systemic sclerosis and risk of cerebrovascular and cardiovascular disease: a meta-analysis

I-Wen Chen  1 , Wei-Ting Wang  2 , Yi-Chen Lai  3 , Chien-Ming Lin  3 , Ping-Hsin Liu  4 , Su-Zhen Wu #  1   5 , Kuo-Chuan Hung #  6
Affiliations
Meta-Analysis

Association between systemic sclerosis and risk of cerebrovascular and cardiovascular disease: a meta-analysis

I-Wen Chen et al. Sci Rep. .

Abstract

We aimed to evaluate the association between systemic sclerosis (SSc) and major cerebrovascular/cardiovascular risks through a systematic approach. Databases were systematically searched from their inception to October 10, 2023 for studies comparing cerebrovascular/cardiovascular event rates between patients with SSc and controls. The primary outcome was the stroke risk in patients with SSc. Secondary outcomes included risk of myocardial infarction (MI), cardiovascular disease (CVD), peripheral vascular disease (PVD), and venous thromboembolism (VTE). Seventeen studies with 6,642,297 participants were included. SSc was associated with a significantly increased risk of stroke (HR, 1.64; 95% confidence interval [CI], 1.35-2.01), CVD (HR, 2.12; 95% CI, 1.36-3.3), MI (HR, 2.15; 95% CI, 1.23-3.77), VTE (HR, 2.75; 95% CI, 1.77-4.28), and PVD (HR, 5.23; 95% CI, 4.25-6.45). Subgroup analysis revealed a significantly increased stroke risk in the non-Asian group (HR, 1.55; 95% CI, 1.26-1.9), while the Asian group displayed a higher but not statistically significant risk (HR, 1.86; 95% CI, 0.97-3.55). The study found that SSc is associated with a significantly increased risk of cerebrovascular/cardiovascular events. These findings highlight the importance of vasculopathy in SSc and suggest the need for enhanced clinical monitoring and preventive measures in this high-risk population.

Keywords: Cardiovascular disease; Myocardial infarction; Stroke; Systemic sclerosis; Vasculopathy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study selection on the association between systemic sclerosis (SSc) and risk of cerebrovascular and cardiovascular disease (CVD).
Figure 2
Figure 2
Forest plot showing the association between systemic sclerosis (SSc) and stroke risk. CI confidence interval, IV inverse variance, SE standard error.
Figure 3
Figure 3
Subgroup analysis on stroke risk based on ethnicity (e.g., non-Asian vs. Asian). CI confidence interval, IV inverse variance, SE standard error.
Figure 4
Figure 4
Subgroup analysis of stroke risk in patients with systemic sclerosis (SSc) versus general population using largest cohort studies from each country. CI confidence interval, IV inverse variance, SE standard error.
Figure 5
Figure 5
Forest plot showing the association between systemic sclerosis (SSc) and cardiovascular disease (CVD) risk. CI confidence interval, IV inverse variance, SE standard error.
Figure 6
Figure 6
Forest plot showing the association between systemic sclerosis (SSc) and myocardial infarction (MI) risk. CI confidence interval, IV inverse variance, SE standard error.
Figure 7
Figure 7
Forest plot showing the association between systemic sclerosis (SSc) and venous thromboembolism (VTE) risk. CI confidence interval, IV inverse variance, SE standard error.
Figure 8
Figure 8
Forest plot showing the association between systemic sclerosis (SSc) and peripheral vascular disease (PVD) risk. CI confidence interval, IV inverse variance, SE standard error.
Figure 9
Figure 9
Forest plot showing the association between systemic sclerosis (SSc) and the risks of other cardiac-related complications. CI confidence interval, IV inverse variance, SE standard error.
Figure 10
Figure 10
Funnel plots indicating a potential publication bias on the association between systemic sclerosis (SSc) and stroke risk. CI confidence interval, IV inverse variance, SE standard error.
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