Sjögren's Syndrome significantly increases risk of heart attack

Patients should be monitored for signs of coronary artery disease and need active management of their cardiovascular risk factors

2014-06-13

(Press-News.org) A new study presented today at the European League Against Rheumatism Annual Congress (EULAR 2014) showed a significantly increased risk of heart attack in patients with Sjögren's syndrome (SjS), particularly in the first year following diagnosis. There was also a trend towards an increased risk for stroke.

SjS is an auto-immune inflammatory disease where the body's immune system attacks glands that secrete fluid, such as the tear and saliva glands.2 Inflammation within the glands reduces fluid production causing painful burning in the eyes, dry mouth, and sometimes dryness in the nasal passages, throat, vagina and skin. Primary SjS occurs in people with no other rheumatological disease; secondary SjS occurs in people who have another rheumatological disease, most often systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). The worldwide prevalence of primary SjS has been estimated at about 0.2% of the adult population, and is thought to affect at least nine times as many women as men.3 Estimates of the prevalence of SjS in patients with RA and SLE vary from 30% and 110% respectively.

According to the principal investigator of the study, Dr. Antonio Aviña-Zubieta, a research scientist at the Arthritis Research Centre of Canada and an Assistant Professor of the Department of Medicine - Division of Rheumatology, University of British Columbia, Vancouver, Canada, "it is the acute inflammatory state in Sjögren's syndrome, particularly at the onset of the disease, which is likely to be the main driver for the increased risk of heart attacks and stroke.

"This is the first general population-based cohort study comparing the relative risk of heart attacks and strokes in patients with new Sjögren's syndrome with age, sex, and entry-matched controls; previously we only had limited data on the relative risks in this specific patient group.

"Our results support the role of inflammation in cardiovascular disease and the need for increased monitoring for coronary artery disease in all patients with this condition, in addition to proper management and modification of their cardiovascular risk factors to reduce the risk of a future heart attack," Dr Aviña-Zubieta the Principal Investigator of the study concluded.

Looking first at the heart attacks, out of 1,176 new cases with SjS, 28 developed a first time heart attack, with an incident rate of 7.7 per 1,000 person-years. Among 11,879 non-SjS matched controls, 138 had a heart attack, with an incident rate of 3.5 per 1,000 person-years.

The results for the stroke cohorts showed that, among 1,195 with new SjS, 19 developed a first-time stroke, with an incident rate of 5.1 per 1,000 person-years. Out of 11,983 non-SjS matched controls, 137 had a CVA event, with an incident rate of 3.4 per 1,000 person-years.

Compared with the age, sex and entry matched controls, the relative risks for heart attack and stroke events were 2.2 (95% CI 1.41- 3.32) and 1.5 (0.9- 2.4), respectively. Adjusting for other relevant risk factors for cardiovascular disease including medications made no significant difference to the relative risk of patients with SjS developing either heart attacks 2.4 (1.5– 3.8) or stroke 1.6 (1.0- 2.8). The risk of developing a heart attack was highest within the first year following diagnosis of SjS (3.6 times), and persisted up to five years following the initial diagnosis. This trend was not seen for strokes.

This was a retrospective matched cohort study with new SjS patients satisfying at least one of the following criteria: diagnosis of SjS (ICD-9-CM code 710.2, ICD-10-CM code M35.0) in adults on at least two visits at least two months apart and within a two-year period between 1996 and 2010 by a non-rheumatologist physician diagnosis of SjS on at least one visit by a rheumatologist or from hospitalisation. cases with diagnostic codes for SjS between 1990 and 1995 were excluded with the intention to select only new SjS cases.

Incident heart attack and stroke events were recorded based on hospitalisation or death certificate. To estimate relative risks, SjS patients were compared with age-, sex- and entry time-matched comparison cohorts, adjusting for potential cardiovascular risk factors. Ten non-SjS controls matched by birth year, sex and calendar year of follow-up were selected from the general population for each case of SjS.

INFORMATION: Abstract Number: OP0212

NOTES TO EDITORS: For further information on this study, or to request an interview with the study lead, please contact us via: EULAR congress Press Office: Room 104, Palais des congrès de Paris Email: eularpressoffice@cohnwolfe.com Onsite tel: +44 (0) 7880 173209 Twitter: @EULAR_Press

About EULAR The European League Against Rheumatism (EULAR) is an umbrella organisation which represents scientific societies, health professional associations and organisations for people with rheumatic diseases throughout Europe.

EULAR aims to promote, stimulate and support the research, prevention, and treatment of rheumatic diseases and the rehabilitation of those it affects. With 45 scientific member societies, 35 People with Arthritis and Rheumatism in Europe (PARE) organisations, 17 health professionals associations and 26 corporate members, EULAR highlights the importance of combating rheumatic diseases through both medical means and patient care.

EULAR 2014 is set to be the biggest rheumatology event in Europe with almost 14,000 scientists, physicians, allied health professionals and related audiences in attendance from 130 countries. Over the course of the congress there will be 302 oral and 1,806 poster abstract presentations, 155 sessions, 725 lectures, 33 poster tours with 421 invited speakers. To find out more about the activities of EULAR, visit: http://www.eular.org

1Yurkovich M, Sayre EC, Shojania K, Avina-Zubieta A. The risk of myocardial infarction and cerebrovascular accident in patients with Sjögren's syndrome: a general population-based cohort study. EULAR 2014; Paris: OP0212 2Wise C. Sjögren's Syndrome. American College of Rheumatology. http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Sj%C3%B6gren_s_Syndrome/ [Accessed 05/06/2014] 3 Westhoff G, Zink A. Epidemiology of primary Sjörgren's syndrome. Z Rheumatol. 2010; 69(1): 41-9 4 Borchers, A. T., Naguwa, S. M., Keen, C. L. & Gershwin, M. E. Immunopathogenesis of Sjögren's syndrome. Clin. Rev. Allergy Immunol 2003; (1):89-104

ELSE PRESS RELEASES FROM THIS DATE:

Biomarkers predict long-term outcomes in juvenile idiopathic arthritis

2014-06-13

Data presented today at the European League Against Rheumatism Annual Congress (EULAR 2014) demonstrate the possibility of using biomarkers (developed from whole blood gene expression profiles) in children with juvenile idiopathic arthritis (JIA) to predict the status of their disease at 12 months. The long-term disease status at 12 months was accurately predicted only after treatment had been initiated, in newly diagnosed patients.1 JIA is the most common childhood* chronic rheumatic disease,2 affecting 16-150 children in every 100,000. As indicated by the name, the ...

Tamoxifen-resistant breast cancer reversed when drug paired with anti-malaria agent

2014-06-13

WASHINGTON — The inexpensive anti-malarial drug hydroxychloroquine (HCQ) reverses resistance to tamoxifen, a widely used breast cancer drug, in mice. In the June 15 issue of Clinical Cancer Research, investigators from Georgetown Lombardi Comprehensive Cancer Center say adding HCQ to tamoxifen could provide a new treatment option for some women with advanced, postmenopausal estrogen receptor-positive (ER+) breast cancer. The ER+ subtype accounts for an estimated 70 percent of all breast cancers. While many of these women are treated with tamoxifen, which blocks estrogen ...

New research shows Western Amazon under threat from oil pollution

2014-06-13

A new study of pollution records indicates that the Western Amazon, an area of unparalleled biological and cultural diversity, may have been contaminated by widespread oil pollution over a 30-year period. This work will be presented at the Goldschmidt conference in Sacramento, California Most of the world's tropical rainforests contain oil and gas reserves. Oil production started in the Western Amazon in the 1920s and peaked in the 1970s, but current growing global demand is stimulating a renewed growth in oil and gas extraction. Nearly 70% of the Peruvian Amazon was ...

Study shows gut microbe composition different in young children with and without type 1 diabetes

2014-06-13

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that children diagnosed with type 1 diabetes have a less balanced composition of gut bacteria compared with children of the same age without diabetes. The research is by Dr Marcus de Goffau and Dr Hermie Harmsen, University Medical Center Groningen, the Netherlands, and colleagues. The incidence of type 1 diabetes is increasing worldwide, showing a particularly sharp increase among children under the age of 5 years. Recent studies indicate that adverse changes ...

Smartphone apps carry higher infection risk than online dating sites or clubs

2014-06-13

Phone dating apps used by gay men to find a sexual partner carry a higher risk of getting common sexually transmitted infections than meeting online or in bars and clubs, suggests research published online in the journal Sexually Transmitted Infections. Previous research has suggested that gay and bi-curious men who meet online are more likely to indulge in unprotected sex and to have more partners than men meeting potential partners in other ways. But since 2009 smartphone apps, such as Grindr, Scruff, and Recon, have become an increasingly popular way to hook up with ...

Use of cement in partial hip replacement linked to risk of death

2014-06-13

The use of cement in partial hip replacement surgery may be linked to a risk of death - often occurring within minutes - finds research published in the online journal BMJ Open. The risk is relatively rare. But the alarm was first sounded in 2009, and most of the cases that have come to light have occurred since that date, say the authors, who include the former chief medical officer for England. This suggests that measures to reduce the risks are not being acted on widely enough, they say. They base their findings on an analysis of cases submitted between 2005 and ...

New test detects toxic prions in blood

2014-06-13

The first cases of Mad Cow disease in humans (properly called variant Creutzfeld Jakob Disease, or vCJD) occurred in the late 1990s and are thought to be the consequence of eating contaminated beef products. Since then, several cases of secondary infections caused by transfusions with blood from donors who subsequently developed vCJD have been reported, raising concerns about the safety of blood and blood products. A paper published in PLOS Pathogens on June 12th now describes an assay that can detect prions in blood samples from humans with vCJD and in animals at early ...

Racial survival differences in young dialysis patients significant in poor neighborhoods

2014-06-13

Washington, DC (June 12, 2014) — Among young adult dialysis patients living in poor neighborhoods, blacks have a significantly higher risk of dying while young compared with whites. The findings, which come from a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN), suggest that more work is needed to understand social factors that could worsen outcomes among young black adults with kidney failure. Among young dialysis patients aged 18 to 30 years, blacks are nearly twice as likely as whites to die while still young. The reasons ...

Hereditary disease genes found throughout the human body

2014-06-13

A new study published in PLOS Computational Biology shows that genes associated with hereditary diseases occur throughout the human body. The study, by Esti Yeger-Lotem et al., used network biology to model the interactions between proteins associated with diseases such as Parkinson's in different tissues. Using these networks, they show that proteins carrying the disease are found throughout the body. In tissues vulnerable to hereditary diseases, the networked proteins had unique interactions relevant for the mechanism of the disease. Disease causing genes tend to ...

Processed red meat linked to higher risk of heart failure, death in men

2014-06-12

Men who eat moderate amounts of processed red meat may have an increased risk of incidence and death from heart failure, according to a study in Circulation: Heart Failure, an American Heart Association journal. Processed meats are preserved by smoking, curing, salting or adding preservatives. Examples include cold cuts (ham, salami), sausage, bacon and hot dogs. "Processed red meat commonly contains sodium, nitrates, phosphates and other food additives, and smoked and grilled meats also contain polycyclic aromatic hydrocarbons, all of which may contribute to the increased ...

Sjögren's Syndrome significantly increases risk of heart attack

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: