Cardiac calcium score in systemic sclerosis

Afifi, Naglaa; Khalifa, Maha Mohamed Mohamed; Anany, Alaa Allah Mohamed Mohamed Mahmoud Al; Hassan, Hend Galal Eldeen Mohamed Ali

doi:10.1007/s10067-021-05887-1

Cited by 8 publications

(3 citation statements)

References 31 publications

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“…In addition to primary cardiac involvement, patients with SSc are also at risk of coronary artery disease, with SSc patients having higher calcium scores compared to healthy controls. [ 8 ] This review aims to summarize the evidence of markers that can be diagnostic (to confirm the presence of the condition), prognostic (to identify patients with higher risk of severe disease) or predictive (to determine response to treatment) of primary SSc cardiac involvement to guide future management. [ 9 ]…”

Section: Cardiac Complications Associated With Systemic Sclerosismentioning

confidence: 99%

Biomarkers in the evaluation of cardiac involvement in systemic sclerosis

Masri,

Ng,

Chin

et al. 2024

Rheumatology and Immunology Research

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Systemic sclerosis is a multisystemic disease for which the heart can be affected leading to cardiac complications and mortality. Up to 80% of patients with systemic sclerosis have cardiac involvement with varying levels of severity. Several molecules have been identified that can be used as markers of cardiac involvement. These biomarkers can arise directly from the heart due to cardiac damage from the disease such as cardiac troponins or from the underlying dysregulated immune process itself such as the proinflammatory cytokines including interleukin (IL)-6. This review aims to summarize the evidence on currently known biomarkers that are can be diagnostic, prognostic or predictive of primary cardiac involvement in systemic sclerosis. We also highlight potential new biomarkers based on the current understanding of the disease process. Clinical use of these markers can benefit patients through earlier identification of those with cardiac involvement, many of whom can be asymptomatic in the early stage, with higher risk of complications, with the overall goal to improve outcomes of these affected patients.

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Section: Cardiac Complications Associated With Systemic Sclerosismentioning

confidence: 99%

Biomarkers in the evaluation of cardiac involvement in systemic sclerosis

Masri,

Ng,

Chin

et al. 2024

Rheumatology and Immunology Research

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“…Multiple large cohort studies showed a twofold increased risk for myocardial infarction and stroke and a four-to fivefold increased risk for peripheral vascular disease in SSc patients [9][10][11]. Previously, it was reported that SSc patients have significantly increased carotid intima-media thickness (cIMT) [12,13] and a greater cardiac coronary calcium score (CSS) [14]. Even after adjustment for traditional cardiovascular risk factors, the association between SSc and atherosclerosis persists, suggesting a diseasespecific role for inflammation, endothelial and microvascular dysfunction, and subsequent vasculopathy [11].…”

Section: Introductionmentioning

confidence: 99%

Plasma Dephosphorylated-Uncarboxylated Matrix Gla-Protein in Systemic Sclerosis Patients: Biomarker Potential for Vascular Calcification and Inflammation

Potjewijd,

Tobal,

Boomars

et al. 2023

Diagnostics

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Background: Systemic sclerosis (SSc) patients face an elevated risk of cardiovascular disease (CVD), even when classic cardiovascular risk factors are considered. Plasma dephosphorylated-uncarboxylated Matrix Gla-protein (dp-ucMGP), an inactive form of MGP, is associated with increased CVD risk. Smooth muscle cells, implicated in SSc’s development, are the primary dp-ucMGP producers. This study assessed dp-ucMGP levels and initial CVD events in early-diagnosed SSc patients, investigating its potential as a CVD and all-cause mortality predictor over time. Methods: In a cohort of 87 SSc patients (excluding those with pre-existing CVD or on dialysis), baseline dp-ucMGP levels were measured, along with cardiovascular risk factors. Validation involved assessing dp-ucMGP in a subset of treatment-naive SSc patients. Results: A significantly elevated median dp-ucMGP level of 634 pmol/L (IQR 301) compared with healthy controls (dp-ucMGP < 393 pmol/L; p < 0.001) was observed. Validation in a treatment-naive SSc patient subset yielded similar results (median 589 pmol/L; IQR 370). During a median 10.5-year follow-up among 78 SSc patients, 33.3% experienced their first CVD event, independent of traditional risk factors. Elevated dp-ucMGP levels (>634 pmol/L) correlated with a higher risk of CVD and/or death (log-rank test: p < 0.01). Conclusions: In summary, dp-ucMGP emerges as a novel biomarker in SSc patients, with elevated levels indicating an increased risk of CVD and/or mortality in this population.

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“…The study showed that patients with SSc have a cardiovascular risk induced by calcification of the coronary atheroma plaque. 12 Atherosclerosis is the result of an inflammatory process mediated by monocytes and macrophages, T lymphocytes, cytokines and autoantibodies. Autoimmune diseases are caused by chronic inflammation that involves a cardiovascular risk.…”

Section: Introductionmentioning

confidence: 99%

CREST Syndrome in Systemic Sclerosis Patients – Is Dystrophic Calcinosis a Key Element to a Positive Diagnosis?

Bobeică¹,

Niculeț²,

Crăescu³

et al. 2022

JIR

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Introduction CREST syndrome is a clinical entity associated with systemic sclerosis, which meets at least three of the five clinical features: calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. Three of these clinical features (Raynaud’s phenomenon, sclerodactyly and esophageal dysmotility) are often present in classical subsets of SSc: limited and diffuse, and their presence in association does not define CREST syndrome. Calcinosis seems to be less common in SSc and its association with other clinical features is characteristic of CREST syndrome. Therefore, it can be appreciated that calcinosis is the key element of CREST syndrome. Methods This study included a number of 37 candidates with SSc, diagnosed with the help of the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) 2013 criteria. Results and Discussions These three elements (calcinosis, Raynaud’s phenomenon, esophageal dysmotility) were recorded both in the limited subset of SSc, but especially in the subset of diffuse SSc, contrary to the data in the literature. Conclusion We appreciate that CREST syndrome is a clinical entity that can overlap with both subsets of SSc. Given the divergent views of the authors on the classification of CREST syndrome, future studies may contribute to a reassessment of SSc classification.

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Cardiac calcium score in systemic sclerosis

Cited by 8 publications

References 31 publications

Biomarkers in the evaluation of cardiac involvement in systemic sclerosis

Biomarkers in the evaluation of cardiac involvement in systemic sclerosis

Plasma Dephosphorylated-Uncarboxylated Matrix Gla-Protein in Systemic Sclerosis Patients: Biomarker Potential for Vascular Calcification and Inflammation

CREST Syndrome in Systemic Sclerosis Patients – Is Dystrophic Calcinosis a Key Element to a Positive Diagnosis?

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