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Observational Study
. 2025 Mar 12;11(1):e005276.
doi: 10.1136/rmdopen-2024-005276.

Cardiovascular events in patients with myositis: results from a French retrospective cohort

Camille Kasser  1 , Alexis F Guédon  1   2 , Yves Allenbach  3 , Olivier Fain  1 , Ariel Cohen  4 , Arsène Mekinian  5
Affiliations
Observational Study

Cardiovascular events in patients with myositis: results from a French retrospective cohort

Camille Kasser et al. RMD Open. .

Abstract

Introduction: Idiopathic inflammatory myositis (IIM) are systemic diseases, including dermatomyositis (DM), inclusion body myositis (IBM), immune-mediated necrotising myopathy (IMNM), antisynthetase syndrome (ASSD) and overlap myositis (OM). Patients with IIM have an increased risk of premature death, largely due to cardiovascular events (CVE). The aim of this study was to describe specific and non-specific cardiac involvement in patients with IIM, and to assess the occurrence of CVE.

Methods: We conducted a retrospective observational cohort study of patients with IIM from Saint Antoine University Hospital, Paris, between 1997 and 2020. Cardiac involvement was defined as abnormalities at baseline on ECG, Holter ECG, transthoracic echocardiography, cardiac MRI or elevated cardiac biomarkers. CVE were defined as heart failure due to ischaemia, arrhythmia or conductive block, inflammatory myocarditis or resuscitation department admission.

Results: 78 patients were included (median age 49 years; 67% female); 33 (42%) had DM, 18 (23%) ASSD, 12 (15%) OM, 11 (14%) IMNM and 4 (5%) IBM. Cardiac involvement at diagnosis was present in 12 (15%) patients; 15 (19%) had a CVE during follow-up. Patients with versus without cardiac involvement at diagnosis were more likely to present a CVE (6 (50%) vs 9 (14%); p=0.01). Median (IQR) time to CVE was shorter in patients with cardiac involvement (9 (0-34) vs 84 (26-156) months; p<0.01).

Conclusion: Patients with cardiac involvement at myositis diagnosis are at increased risk of CVE and experience them earlier than patients without and should be carefully followed up, particularly during the first months after diagnosis.

Keywords: Cardiovascular Diseases; Dermatomyositis; Inflammation; Polymyositis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Flowchart. IIM, idiopathic inflammatory myositis.
Figure 2
Figure 2. Time to cardiovascular event in myositis patients with cardiac involvement and without cardiac involvement at diagnosis. *P<0.001 using log-rank test.
Figure 3
Figure 3. Time to cardiovascular event in myositis patients with specific cardiac involvement and without specific cardiac involvement at diagnosis. *P<0.001 using log-rank test.
See this image and copyright information in PMC

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