Vasodilators and low-dose acetylsalicylic acid are associated with a lower incidence of distinct primary myocardial disease manifestations in systemic sclerosis: results of the DeSScipher inception cohort study

Gabriele Valentini*, Dörte Huscher, Antonella Riccardi, Serena Fasano, Rosaria Irace, Valentina Messiniti, Marco Matucci-Cerinic, Serena Guiducci, Oliver Distler, Britta Maurer, Jérôme Avouac, Ingo H. Tarner, Marc Frerix, Gabriela Riemekasten, Elise Siegert, László Czirják, Veronika Lóránd, Christopher P. Denton, Svetlana Nihtyanova, Ulrich A. WalkerVeronika K. Jaeger, Francesco Del Galdo, Giuseppina Abignano, Lidia P. Ananieva, Ana Maria Gherghe, Carina Mihai, Joerg Christoph Henes, Tim Schmeiser, Alessandra Vacca, Sergey Moiseev, Ivan Foeldvari, Armando Gabrielli, Brigitte Krummel-Lorenz, Simona Rednic, Yannick Allanore, Ulf Müeller-Ladner

*Korrespondierende/r Autor/-in für diese Arbeit
8 Zitate (Scopus)

Abstract

Objectives To investigate the influence of vasodilator drugs on the occurrence of features depending on myocardial ischaemia/fibrosis (ventricular arrhythmias, Q waves, cardiac blocks, pacemaker implantation, left ventricular ejection fraction (LVEF) <55%, and/or congestive heart failure and sudden cardiac death) in systemic sclerosis (SSc). Methods 601 patients with SSc were enrolled from 1 December 2012 to 30 November 2015 and had a second visit 0.5-4 years apart. 153 received no vasodilators; 448 received vasodilator therapy (ie, calcium channel blockers and/or ACE inhibitors or angiotensin II receptor blockers or combinations of them), 89 of them being also treated with either endothelin receptor antagonists or PDE5 inhibitors or prostanoids. Associations between the occurrence of myocardial disease manifestations and any demographic, disease and therapeutic aspect were investigated by Cox regression analysis. A Cox frailty survival model with centre of enrolment as random effect was performed. Results During 914 follow-up patient-years, 12 ventricular arrhythmias, 5 Q waves, 40 cardiac blocks, 6 pacemaker implantations and 19 reduced LVEF and/or congestive heart failure (CHF) occurred. In multivariate Cox regression analysis, vasodilator therapy was associated with a lower incidence of ventricular arrhythmias (p=0.03); low-dose acetylsalicylic acid (ASA) with a lower incidence of cardiac blocks and/or Q waves and/or pacemaker implantation (p=0.02); active disease with a higher incidence of LVEF <55% and/or CHF and cardiac blocks and/or Q waves and/or pacemaker implantation (p=0.05). Conclusions The present study might suggest a preventative effect on the occurrence of distinct myocardial manifestations by vasodilator therapy and low-dose ASA.

OriginalspracheEnglisch
ZeitschriftAnnals of the Rheumatic Diseases
Jahrgang78
Ausgabenummer11
Seiten (von - bis)1576-1582
Seitenumfang7
ISSN0003-4967
DOIs
PublikationsstatusVeröffentlicht - 01.11.2019

Strategische Forschungsbereiche und Zentren

  • Forschungsschwerpunkt: Infektion und Entzündung - Zentrum für Infektions- und Entzündungsforschung Lübeck (ZIEL)

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